Provider Demographics
NPI:1962719591
Name:QURESHI, LAEEQ AHMAD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAEEQ
Middle Name:AHMAD
Last Name:QURESHI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8736 E BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-4016
Mailing Address - Country:US
Mailing Address - Phone:520-546-1378
Mailing Address - Fax:
Practice Address - Street 1:103 W ELM ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-6537
Practice Address - Country:US
Practice Address - Phone:520-791-0231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS012135183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist