Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | MD 064518-L | PA |
N | 2080P0204X | Pediatric Emergency Doctor | 35-132009 | OH |
NPI | 1326099276 |
---|---|
Provider Name | Dr. Eileen C Quintana |
First Address | Highland Hills, OH 44122-7250 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 27/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0017977900008 | (05) | PA |
H06908 | (02) |