Provider Demographics
NPI:1295091122
Name:QUITONI, RICHARD CHARLES
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:CHARLES
Last Name:QUITONI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 446
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-0446
Mailing Address - Country:US
Mailing Address - Phone:845-234-7304
Mailing Address - Fax:
Practice Address - Street 1:1577 ROUTE 211 E
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-3730
Practice Address - Country:US
Practice Address - Phone:845-234-7304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY970290846344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi