Provider Demographics
NPI:1235231051
Name:QUINTAS, JOHN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:QUINTAS
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:695 DUTCHESS TPKE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-6442
Mailing Address - Country:US
Mailing Address - Phone:888-647-5979
Mailing Address - Fax:845-454-3693
Practice Address - Street 1:695 DUTCHESS TPKE
Practice Address - Street 2:SUITE 105
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-6442
Practice Address - Country:US
Practice Address - Phone:888-647-5979
Practice Address - Fax:845-454-3693
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1947522085R0202X
NJ25MA075693002085R0202X
AZ314192085R0202X
CT0411742085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG78147Medicare UPIN