Healthcare Provider Details

I. General information

NPI: 1275352528
Provider Name (Legal Business Name): WENQI QIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2024
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8045 WINCHESTER BLVD BLDG 73
QUEENS VILLAGE NY
11427-2195
US

IV. Provider business mailing address

8045 WINCHESTER BLVD BLDG 73
QUEENS VILLAGE NY
11427-2195
US

V. Phone/Fax

Practice location:
  • Phone: 718-264-3338
  • Fax:
Mailing address:
  • Phone: 718-264-3338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number123726
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: