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General NPI Number Information
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NPI Number | 1437970530
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Entity Type | Organization
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Legal Business Name | QUANTUM MEDICAL DIAGNOSTIX PLLC
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 560 NORTHERN BLVD STE 204A
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City | GREAT NECK
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State | NY
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Zip | 11021-5113
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Country | US
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Telephone | 973-779-7361
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Fax |
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Provider Business Mailing Address
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Address Line | 311 E 23RD ST APT 6AA
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City | NEW YORK
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State | NY
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Zip | 10010-4740
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | SIMON SMITH
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Credential |
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Telephone | 814-746-6678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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