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General NPI Number Information
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NPI Number | 1831611425
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Entity Type | Organization
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Legal Business Name | QDM ENTERPRISE INC
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Dates
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Enumeration Date | 07/14/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 215 ACKERMAN ST
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City | CENTRAL ISLIP
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State | NY
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Zip | 11722-3601
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Country | US
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Telephone | 917-287-5217
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Fax | 631-415-4420
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Provider Business Mailing Address
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Address Line | 215 ACKERMAN ST
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City | CENTRAL ISLIP
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State | NY
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Zip | 11722-3601
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Country | US
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Telephone | 917-287-5217
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Fax | 631-415-4420
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Authorized Official
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Title or Position | OWNER
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Name | ADEWUNMI GREEN
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Credential |
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Telephone | 917-287-5217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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