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Individual

QIN RAO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
55 W 17TH ST, NEW YORK, NY 10011-5513
(212) 427-8761
Mailing address
6940 168TH ST, FRESH MEADOWS, NY 11365-3214
(917) 415-2606

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
298023-01
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MH72715H
NY
Enumeration date
05/08/2015
Last updated
07/20/2022
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