Provider Demographics
NPI:1871774356
Name:QURESHI, MUHAMMAD KHALIQUE
Entity type:Individual
Prefix:MR
First Name:MUHAMMAD
Middle Name:KHALIQUE
Last Name:QURESHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3307 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2711
Mailing Address - Country:US
Mailing Address - Phone:718-856-8048
Mailing Address - Fax:718-469-0424
Practice Address - Street 1:3307 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2339
Practice Address - Country:US
Practice Address - Phone:718-856-8048
Practice Address - Fax:718-469-0424
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041123183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY041123OtherREGISTERD PHARMACIST