Provider Demographics
NPI:1437645165
Name:QUINTERO, EDUARDO ELI (MD)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:ELI
Last Name:QUINTERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EDUARDO
Other - Middle Name:ELI
Other - Last Name:QUINTERO MARIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:EDUARDO ELI QUINTERO
Mailing Address - Street 1:5501 OLD YORK RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-3018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5501 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-3018
Practice Address - Country:US
Practice Address - Phone:215-456-8520
Practice Address - Fax:215-455-1933
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT214832207R00000X
PAMD474496207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine