Provider Demographics
NPI:1417300971
Name:QUINONES, TERESA VICTORIA (RN)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:VICTORIA
Last Name:QUINONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2846 HEATH AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-7802
Mailing Address - Country:US
Mailing Address - Phone:347-374-1245
Mailing Address - Fax:
Practice Address - Street 1:2846 HEATH AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-7802
Practice Address - Country:US
Practice Address - Phone:347-374-1245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400456-1163W00000X
NJ26NR10343900163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse