Provider Demographics
NPI:1679886337
Name:QUARTANA, PHILLIP J (PHD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:J
Last Name:QUARTANA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5510 NATHAN SHOCK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-6823
Mailing Address - Country:US
Mailing Address - Phone:410-550-7984
Mailing Address - Fax:410-550-0117
Practice Address - Street 1:5510 NATHAN SHOCK DR STE 100
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-6823
Practice Address - Country:US
Practice Address - Phone:410-550-7984
Practice Address - Fax:410-550-0117
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist