Healthcare Provider Details

I. General information

NPI: 1922596758
Provider Name (Legal Business Name): NABEEL QURESHI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 ROUTE 88 STE 117
BRICK NJ
08724-3044
US

IV. Provider business mailing address

1608 ROUTE 88 STE 117
BRICK NJ
08724-3044
US

V. Phone/Fax

Practice location:
  • Phone: 732-575-1100
  • Fax: 732-575-1107
Mailing address:
  • Phone: 732-575-1100
  • Fax: 732-575-1107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA11146500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number25MA11146500
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number25MA11146500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: