Provider Demographics
NPI:1154023380
Name:LOSEFSKY, QUINN PATRICIA
Entity type:Individual
Prefix:
First Name:QUINN
Middle Name:PATRICIA
Last Name:LOSEFSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 ATHENIA DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76114-4303
Mailing Address - Country:US
Mailing Address - Phone:512-496-4356
Mailing Address - Fax:
Practice Address - Street 1:203 ATHENIA DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76114-4303
Practice Address - Country:US
Practice Address - Phone:512-496-4356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program