Provider Demographics
NPI:1831639418
Name:QUALTERE, JOAN (RN)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:QUALTERE
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 1:190 HILTON RD
Mailing Address - Street 2:
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-3605
Mailing Address - Country:US
Mailing Address - Phone:518-765-2415
Mailing Address - Fax:
Practice Address - Street 1:190 HILTON RD
Practice Address - Street 2:
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159-3605
Practice Address - Country:US
Practice Address - Phone:518-765-2415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304269-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse