Basic Information
Provider Information
NPI: 1003138769
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: QUINTO
FirstName: JEFFREY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PHARM.D., R.PH.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 150 E 42ND ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100175612
CountryCode: US
TelephoneNumber: 2126618139
FaxNumber:  
Practice Location
Address1: 150 E 42ND ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100175612
CountryCode: US
TelephoneNumber: 2126618139
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/23/2010
LastUpdateDate: 11/15/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X052662NYY Pharmacy Service ProvidersPharmacist 

No ID Information.


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