NPI Code Detail JSON Logo

1205789393 NPI number — QUEENS ATLANTIC MEDICAL, PLLC

NPI Number: 1205789393
Health Care Provider/Practitioner: QUEENS ATLANTIC MEDICAL, PLLC

Information about “1205789393” NPI (QUEENS ATLANTIC MEDICAL, PLLC) exists in 1205789393 in HTML format HTML  |  1205789393 in plain Text format TXT  |  1205789393 in PDF (Portable Document Format) PDF  |  1205789393 in an XML format XML  formats.

NPI Number : 1205789393 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205789393",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "QUEENS ATLANTIC MEDICAL, PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "10919 72ND RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FOREST HILLS",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11375-7826",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "718-268-3161",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "10919 72ND RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FOREST HILLS",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11375-7826",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "718-268-0418",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/18/2026",
    "LastUpdateDate": "02/18/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KHAN",
    "AuthorizedOfficialFirstName": "AZEEM",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "516-578-8271",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207ZD0900X",
          "TaxonomyName": "Dermatopathology (Pathology) Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207N00000X",
          "TaxonomyName": "Dermatology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RG0100X",
          "TaxonomyName": "Gastroenterology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207ZP0101X",
          "TaxonomyName": "Anatomic Pathology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.