Provider Demographics
NPI:1053484865
Name:QUITKIN, OLIVERA JANJIC (MD)
Entity Type:Individual
Prefix:
First Name:OLIVERA
Middle Name:JANJIC
Last Name:QUITKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLIVERA
Other - Middle Name:
Other - Last Name:JANJIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:333 BORTHWICK AVE
Mailing Address - Street 2:PORTSMOUTH ANESTHESIA ASSOCIATES
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7128
Mailing Address - Country:US
Mailing Address - Phone:603-436-5110
Mailing Address - Fax:
Practice Address - Street 1:333 BORTHWICK AVE
Practice Address - Street 2:PORTSMOUTH ANESTHESIA ASSOCIATES
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7128
Practice Address - Country:US
Practice Address - Phone:603-436-5110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD 33502207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC034145800Medicaid
H67070Medicare UPIN
DC009922M83Medicare ID - Type Unspecified