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General NPI Number Information
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NPI Number | 1316261563
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Entity Type | Organization
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Legal Business Name | DQS CARDIAC AND VASCULAR SERVICES, P.C.
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 03/17/2010
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Provider Practice Location Address
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Address Line | 194-13 NORTHERN BLVD.
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City | FLUSHING
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State | NY
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Zip | 11358
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Country | US
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Telephone | 718-357-0298
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Fax |
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Provider Business Mailing Address
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Address Line | 194-13 NORTHERN BLVD.
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City | FLUSHING
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State | NY
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Zip | 11358
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Country | US
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Telephone | 718-357-0298
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DEREK SUN
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Credential | MD
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Telephone | 718-357-0298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 250883
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License Number State | NY
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