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General NPI Number Information
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NPI Number | 1164217006
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Entity Type | Organization
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Legal Business Name | COLON AND RECTAL SURGERY OF QUEENS PLLC
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 6344 SAUNDERS ST
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City | REGO PARK
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State | NY
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Zip | 11374-2039
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Country | US
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Telephone | 347-239-8882
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Fax |
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Provider Business Mailing Address
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Address Line | 6344 SAUNDERS ST
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City | REGO PARK
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State | NY
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Zip | 11374-2039
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Country | US
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Telephone | 718-475-2017
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Fax | 718-475-2046
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Authorized Official
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Title or Position | MANAGING MEMBER / PHYSICIAN
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Name | ARTHUR YUSHUVA
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Credential | MD
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Telephone | 718-475-2017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number |
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License Number State |
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