Provider Demographics
NPI:1386961647
Name:QUARTARARO-BAITER, TERESA MARIE (LPN)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:MARIE
Last Name:QUARTARARO-BAITER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:TERESA
Other - Middle Name:MARIE
Other - Last Name:QUARTARARO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:26 EAST MALL
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4405
Mailing Address - Country:US
Mailing Address - Phone:516-777-7766
Mailing Address - Fax:516-777-7766
Practice Address - Street 1:325 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2779
Practice Address - Country:US
Practice Address - Phone:631-351-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116307-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse