Organization
BASIT QAYYUM D O P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BASIT QAYYUM M.D. (ADMINISTRATOR)
(917) 312-6712
Entity
Organization
Contact information
Practice address
314 E 30TH ST, NEW YORK, NY 10016-8303
(646) 370-2010
Mailing address
PO BOX 655, NEW YORK, NY 10113-0655
(917) 312-6712
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BA0WFW5710
BLUE SHIELD
—
Enumeration date
08/14/2006
Last updated
04/03/2015
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