Provider Information for 1922486125
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QIN RAO
Sex: Male
NPI: 1922486125
Last Updated: 2022-07-20
Certification Date: 2022-07-20
Certification Date: 2022-07-20
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1922486125 | ||||||||||||
| Enumeration Date | 2015-05-08 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 6940 168TH ST FRESH MEADOWS, NY 11365-3214 United States Phone: 917-415-2606 | Fax: | ||||||||||||
| Primary Practice Address | 55 W 17TH ST NEW YORK, NY 10011-5513 United States Phone: 212-427-8761 | Fax: | ||||||||||||
| Secondary Practice Address(es) | DEPT OF MEDICINE | ||||||||||||
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