Provider Demographics
NPI:1982034534
Name:QUINTERO, MARIA FERNANDA (LPN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:FERNANDA
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 W 230TH ST
Mailing Address - Street 2:APT. C2F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-5207
Mailing Address - Country:US
Mailing Address - Phone:347-872-1128
Mailing Address - Fax:
Practice Address - Street 1:231 W 230TH ST
Practice Address - Street 2:APT. C2F
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-5207
Practice Address - Country:US
Practice Address - Phone:347-872-1128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316754164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse