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General NPI Number Information
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NPI Number | 1275060964
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Entity Type | Organization
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Legal Business Name | QSCA LLC
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Dates
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Enumeration Date | 05/12/2017
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Last Update Date | 05/12/2017
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Provider Practice Location Address
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Address Line | 136-20 38TH AVE. SUITE 5I
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City | FLUSHING
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State | NY
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Zip | 11354-4232
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Country | US
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Telephone | 718-939-9200
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Fax | 718-939-7474
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Provider Business Mailing Address
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Address Line | 136-20 38TH AVE. SUITE 5I
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City | FLUSHING
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State | NY
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Zip | 11354-4232
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Country | US
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Telephone | 718-939-9200
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Fax | 718-939-7474
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Authorized Official
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Title or Position | DIRECTOR
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Name | KATHERINE LIU
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Credential | MD
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Telephone | 718-939-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 286624
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License Number State | NY
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