MEDICARE: EDWIN QUASHIE NNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LN0000X	Neonatal Nurse Practitioner	F350527-01	NY

General Provider Information

NPI Number	:	1356015176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWIN QUASHIE NNP

Provider Business Mailing Address
First Line	:	203 NEWARK AVE REAR HOUSE
Second Line	:
City	:	BRADLEY BEACH
State	:	NJ
Zip	:	07720-1532
Country	:	US
Telephone Number	:	646-379-8090
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 NEWARK AVE REAR HOUSE
Second Line	:
City	:	BRADLEY BEACH
State	:	NJ
Zip	:	07720-1532
Country	:	US
Telephone Number	:	646-379-8090
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2021
Last Update Date	:	12/12/2024

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