Provider Demographics
NPI:1215469572
Name:QUARTARONE, ANTONINO MARIO (CSA)
Entity type:Individual
Prefix:DR
First Name:ANTONINO
Middle Name:MARIO
Last Name:QUARTARONE
Suffix:
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 ROSE GALAXY LNDG
Mailing Address - Street 2:APT. 202
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-7771
Mailing Address - Country:US
Mailing Address - Phone:757-754-1795
Mailing Address - Fax:
Practice Address - Street 1:1205 ROSE GALAXY LNDG
Practice Address - Street 2:APT. 202
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-7771
Practice Address - Country:US
Practice Address - Phone:757-754-1795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant