Healthcare Provider Details

I. General information

NPI: 1578019584
Provider Name (Legal Business Name): QCW MEDICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2016
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 88TH ST
JACKSON HEIGHTS NY
11372-7662
US

IV. Provider business mailing address

10119 JAMAICA AVE
RICHMOND HILL NY
11418-2008
US

V. Phone/Fax

Practice location:
  • Phone: 929-949-5900
  • Fax: 347-579-0037
Mailing address:
  • Phone: 718-709-4721
  • Fax: 718-709-4733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number281921-1
License Number StateNY

VIII. Authorized Official

Name: DR. JEANNETTE ELIZABETH CANO-LANDIVAR
Title or Position: MEDICAL DOCTOR
Credential:
Phone: 929-949-5900