Provider Demographics
NPI:1891711453
Name:QUENTIN MEDICAL, P.C
Entity Type:Organization
Organization Name:QUENTIN MEDICAL, P.C
Other - Org Name:QUENTIN MEDICAL, P.C
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNSHTEYN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-380-4750
Mailing Address - Street 1:280 QUENTIN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1628
Mailing Address - Country:US
Mailing Address - Phone:718-380-4750
Mailing Address - Fax:
Practice Address - Street 1:280 QUENTIN RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1628
Practice Address - Country:US
Practice Address - Phone:718-380-4750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02556141Medicaid
NY06187Medicare ID - Type Unspecified