Provider Demographics
NPI:1164217006
Name:COLON AND RECTAL SURGERY OF QUEENS PLLC
Entity type:Organization
Organization Name:COLON AND RECTAL SURGERY OF QUEENS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER / PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:YUSHUVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-239-8882
Mailing Address - Street 1:6448 BOOTH ST APT 4E
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4016
Mailing Address - Country:US
Mailing Address - Phone:347-239-8882
Mailing Address - Fax:
Practice Address - Street 1:6344 SAUNDERS ST
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2039
Practice Address - Country:US
Practice Address - Phone:347-239-8882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty