Provider Demographics
NPI:1205497955
Name:QUORUM VITALS INC
Entity type:Organization
Organization Name:QUORUM VITALS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETRONELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTOHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-451-0367
Mailing Address - Street 1:12 PITCHER WAY
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5298
Mailing Address - Country:US
Mailing Address - Phone:516-451-0367
Mailing Address - Fax:
Practice Address - Street 1:16410 NORTHERN BLVD STE 206
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-2668
Practice Address - Country:US
Practice Address - Phone:718-321-2940
Practice Address - Fax:718-321-2942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty