Individual
OSCAR R QUEZADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
31 MAIN RD, RIVERHEAD, NY 11901-1953
(361) 727-4950
Mailing address
6 BEATTY RD, SHOREHAM, NY 11786-1053
(915) 227-2117
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
273139
NY
207V00000X
Obstetrics & Gynecology Physician
K7471
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03872997
—
NY
05
—
1459521-04
—
TX
05
—
1459521-05
—
TX
01
—
273139
NYS LICENSE
NY
Enumeration date
10/06/2006
Last updated
10/17/2020
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