| Express Clinic LLC | |
|
724 Maiden Choice Ln Ste 201 Catonsville MD 21228-5962 | |
| (410) 650-4121 | |
| (866) 948-8535 |
| Full Name | Express Clinic LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 724 Maiden Choice Ln Ste 201, Catonsville, Maryland |
| Authorized Official Name and Position | Jazibeh Qureshi (OWNER) |
| Authorized Official Contact | 4106504121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Express Clinic LLC 11321 Megan Lynn Ct Marriottsville MD 21104-1658 Ph: (410) 650-4121 | Express Clinic LLC 724 Maiden Choice Ln Ste 201 Catonsville MD 21228-5962 Ph: (410) 650-4121 |
| NPI Number | 1285220830 |
|---|---|
| Provider Enumeration Date | 12/17/2020 |
| Last Update Date | 09/20/2021 |
| Certification Date | 09/20/2021 |
| Medicare PECOS PAC ID | 3577979038 |
|---|---|
| Medicare Enrollment ID | O20210308001445 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285220830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| 207R00000X | Internal Medicine | () | Secondary |
| Provider Name | Azra Hasan Hussaini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245343987 PECOS PAC ID: 2961578208 Enrollment ID: I20161228001246 |
| Provider Name | Jaspreet Kaur |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679300255 PECOS PAC ID: 1052806874 Enrollment ID: I20260120002145 |
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