=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740924810
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PULSE MEDICAL CARE, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2022
-----------------------------------------------------
Last Update Date | 04/25/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4109 108TH ST STE 1
-----------------------------------------------------
City | CORONA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11368-2355
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-986-1010
-----------------------------------------------------
Fax | 516-465-1105
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 130 JERICHO TPKE SUITE D
-----------------------------------------------------
City | VALLEY STREAM
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11580
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-986-1010
-----------------------------------------------------
Fax | 516-465-1105
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN/OWNER
-----------------------------------------------------
Name | ADNAN MIDDLE NAME QURESHI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 516-986-1010
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207LP2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2081P2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------