Healthcare Provider Details

I. General information

NPI: 1790355444
Provider Name (Legal Business Name): REHAN FARRUKH QURESHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2021
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 CENTRAL AVE
PHILADELPHIA PA
19111-2442
US

IV. Provider business mailing address

3900 CITY AVE APT M601
PHILADELPHIA PA
19131-2943
US

V. Phone/Fax

Practice location:
  • Phone: 215-728-2275
  • Fax: 215-214-4119
Mailing address:
  • Phone: 905-541-4994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD484247
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: