1265493860 NPI number — CHARITO V QUINTERO-HOWARD M.D.

Table of content: CHARITO V QUINTERO-HOWARD M.D. (NPI 1265493860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265493860 NPI number — CHARITO V QUINTERO-HOWARD M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
QUINTERO-HOWARD
Provider First Name:
CHARITO
Provider Middle Name:
V
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
QUINTERO
Provider Other First Name:
CHARITO
Provider Other Middle Name:
V
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1265493860
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/08/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 E JOPPA RD
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
TOWSON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21286-3260
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-337-0007
Provider Business Mailing Address Fax Number:
410-337-0071

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 EAST JOPPA ROAD
Provider Second Line Business Practice Location Address:
SUITE 106, THE RIDGELY
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21286
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-337-0007
Provider Business Practice Location Address Fax Number:
410-337-0071
Provider Enumeration Date:
03/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  D0055174 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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