Organization Active NPI

Queens Atlantic Medical, PLLC

  • Anatomic Pathology Physician
  • Forest Hills, NY
National Provider Identifier
1205789393
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
Legal business name
QUEENS ATLANTIC MEDICAL, PLLC
Practice address
10919 72ND Rd
Forest Hills, NY 11375-7826
Phone
(718) 268-0418
NPI assigned
Feb 18, 2026
Last updated
Feb 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Azeem Khan, MDNPI 1538183678
Title
Owner
Phone
(718) 268-0418

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X
Gastroenterology Physician 207RG0100X
Dermatopathology (Pathology) Physician 207ZD0900X
Anatomic Pathology Physician 207ZP0101X Primary

Addresses

Primary practice location

10919 72ND Rd
Forest Hills, NY 11375-7826

Mailing address

10919 72ND Rd
Forest Hills, NY 11375-7826
Phone (718) 268-0418

Other practice location 1

19812 Hillside Ave
Hollis, NY 11423-2161
Phone (718) 268-0418

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1771372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771804800000",
    "number": "1205789393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10919 72ND RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757826",
            "telephone_number": "718-268-0418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10919 72ND RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757826",
            "telephone_number": "718-268-0418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19812 Hillside Ave",
            "address_purpose": "LOCATION",
            "city": "Hollis",
            "state": "NY",
            "postal_code": "114232161",
            "country_code": "US",
            "telephone_number": "718-268-0418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "QUEENS ATLANTIC MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-18",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "AZEEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-268-0418",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.