712 5TH AVENUE, NEW YORK, 10019, NEW YORK
| Entity Name | BASIT QAYYUM, D.O., P.C. |
| Entity Number | 3135327 |
| Status | ACTIVE |
| Incorporation Date | 8th December 2004 |
| Dos Process Address | 434 WEST 19TH STREET, NEW YORK, 10011, NEW YORK |
| Jurisdiction | NEW YORK |
| County | NEW YORK |
| Legal form | DOMESTIC PROFESSIONAL CORPORATION |