Shazia I Basir Quddusi

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

9777 Queens Blvd
PH
Rego Park, NY 11374-3335

Phone

(718) 218-5439

Fax

(718) 228-4434

NPI assigned

Jun 13, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1417219692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PRIMROSE AVE",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118011617",
            "telephone_number": "718-218-5439",
            "fax_number": "718-228-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 QUEENS BLVD",
            "address_2": "PH",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743335",
            "telephone_number": "718-218-5439",
            "fax_number": "718-228-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASIR QUDDUSI",
        "first_name": "SHAZIA",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SERVICE COORDINATION",
            "identifier": "16472",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ella Bartov, PT
• Barukh Medical Transportation Inc.
• Deysi Veronica Barzallo, LCSW
• Nadine Lucia Bascombe, DPT
• Marvin J Base, M.D.
• Elizabeth Bassano, LCSW-R
• Carlos M Bastidas, RN-BSN
• Maia V Batash, MD
• Steven Batash, M.D.
• David Baum

• Early Intervention Provider Agency in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.