Provider Demographics
NPI:1558780312
Name:DE DIOS QUINTERO, ANGEL ENRIQUE (MD)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:ENRIQUE
Last Name:DE DIOS QUINTERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5702 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-2718
Mailing Address - Country:US
Mailing Address - Phone:201-681-7402
Mailing Address - Fax:
Practice Address - Street 1:100 THE AMERICAN RD
Practice Address - Street 2:
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-2443
Practice Address - Country:US
Practice Address - Phone:973-867-7349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10532000207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology