Individual provider Active NPI

Anjum Afshan Qureshi

  • Physical Therapist
  • Jamaica, NY
National Provider Identifier
1639341597
Registry record updated Nov 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
022953 Issued in NY
Practice address
8742 169TH St
Jamaica, NY 11432-3632
Phone
(718) 739-2200
Fax
(718) 526-2830
NPI assigned
Mar 31, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 022953 NY Primary

Addresses

Primary practice location

8742 169TH St
Jamaica, NY 11432-3632

Mailing address

24 Fairfax St
Valley Stream, NY 11580-3515
Phone (718) 739-2200

Other identifiers 1

IdentifierTypeStateIssuer
03028535MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
022953NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Vision Physical Therapy and Rehab Physical Therapist Current Accepting new patients

Locations

8742 169th St
Jamaica, NY 11432
Phone (718) 206-2222

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1639341597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FAIRFAX ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115803515",
            "telephone_number": "718-739-2200",
            "fax_number": "718-526-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8742 169TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323632",
            "telephone_number": "718-739-2200",
            "fax_number": "718-526-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "ANJUM",
        "middle_name": "AFSHAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03028535",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.