Provider Demographics
NPI:1912431321
Name:QUEENS MEDICAL HEALTH WELLNESS PC
Entity type:Organization
Organization Name:QUEENS MEDICAL HEALTH WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:SHAHBANO
Authorized Official - Last Name:AFRIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-860-8307
Mailing Address - Street 1:21318 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3522
Mailing Address - Country:US
Mailing Address - Phone:718-465-3200
Mailing Address - Fax:
Practice Address - Street 1:21318 UNION TPKE
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-3522
Practice Address - Country:US
Practice Address - Phone:718-465-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-12
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2382962086S0122X
NY133980207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty