Provider Demographics
NPI:1932241593
Name:QUARTIER, NEAL E (PHD LCSW BCD)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:E
Last Name:QUARTIER
Suffix:
Gender:M
Credentials:PHD LCSW BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N STATE STREET
Mailing Address - Street 2:PO BOX 6482
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13217-6482
Mailing Address - Country:US
Mailing Address - Phone:315-470-1462
Mailing Address - Fax:315-474-1045
Practice Address - Street 1:215 N STATE STREET
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13217-6482
Practice Address - Country:US
Practice Address - Phone:315-470-1462
Practice Address - Fax:315-474-1045
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR03776511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5847312OtherAETNA
NY7404785OtherVALUE OPTIONS
NY02303524Medicaid
NYA1024573OtherVALUE BEHAVORIAL HEALTH
NYYO26450OtherCHAMPUS
NYIA0537Medicare ID - Type Unspecified