Basic Information
| Provider Information | |||||||||
| NPI: | 1518267731 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUINTANA | ||||||||
| FirstName: | LIZA | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 330 BROOKLINE AVENUE | ||||||||
| Address2: | BETH ISRAEL DEACONESS MEDICAL CENTER DEPT OF PATHOLOGY | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176674344 | ||||||||
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| Practice Location | |||||||||
| Address1: | 330 BROOKLINE AVENUE | ||||||||
| Address2: | BETH ISRAEL DEACONESS MEDICAL CENTER DEPT OF PATHOLOGY | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176674344 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2010 | ||||||||
| LastUpdateDate: | 10/22/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | 244140 | MA | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.