Healthcare Provider Details

I. General information

NPI: 1063339596
Provider Name (Legal Business Name): DANIYAL QASIM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 W MAIN ST UNIT 5025
HUNTINGTON NY
11743-3203
US

IV. Provider business mailing address

375 W MAIN ST UNIT 5025
HUNTINGTON NY
11743-3203
US

V. Phone/Fax

Practice location:
  • Phone: 516-500-0519
  • Fax:
Mailing address:
  • Phone: 516-500-0519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: