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General NPI Number Information
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NPI Number | 1265978365
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Entity Type | Organization
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Legal Business Name | JIN QIU MD PC
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Dates
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Enumeration Date | 01/12/2017
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Last Update Date | 01/12/2017
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Provider Practice Location Address
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Address Line | 141 E 55TH ST APT 4C APT 4C
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City | NEW YORK
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State | NY
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Zip | 10022-4050
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Country | US
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Telephone | 646-201-0268
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Fax | 347-527-9166
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Provider Business Mailing Address
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Address Line | 141 E 55TH ST APT 4C APT 4C
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City | NEW YORK
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State | NY
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Zip | 10022-4050
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Country | US
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Telephone | 646-201-0268
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Fax | 347-527-9166
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Authorized Official
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Title or Position | PRESIDENT
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Name | JIN QIU
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Credential | M.D.
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Telephone | 646-201-0268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | NY198620
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License Number State | NY
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