Provider Demographics
NPI:1518267731
Name:QUINTANA, LIZA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:LIZA
Middle Name:MARIE
Last Name:QUINTANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 BROOKLINE AVENUE
Mailing Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTER DEPT OF PATHOLOGY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02212
Mailing Address - Country:US
Mailing Address - Phone:617-667-4344
Mailing Address - Fax:
Practice Address - Street 1:330 BROOKLINE AVENUE
Practice Address - Street 2:BETH ISRAEL DEACONESS MEDICAL CENTER DEPT OF PATHOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02212
Practice Address - Country:US
Practice Address - Phone:617-667-4344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA244140207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology