Provider Demographics
NPI:1336929322
Name:QUIROS, APOLLONIA (PA-C)
Entity Type:Individual
Prefix:
First Name:APOLLONIA
Middle Name:
Last Name:QUIROS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 SPRUCE ST APT 4C
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5689
Mailing Address - Country:US
Mailing Address - Phone:267-271-4925
Mailing Address - Fax:
Practice Address - Street 1:4745 OGLETOWN STANTON RD STE 217
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2074
Practice Address - Country:US
Practice Address - Phone:302-733-2410
Practice Address - Fax:302-733-2606
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0011971363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical