MEDICARE: MS. ELIZABETH QUINT NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F331099-1	NY

General Provider Information

NPI Number	:	1750416822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH QUINT NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	564 10TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-4402
Country	:	US
Telephone Number	:	718-768-8647
Fax Number	:

Provider Business Practice Location Address
First Line	:	544 7TH AVE RM 103
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-6140
Country	:	US
Telephone Number	:	718-788-6720
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	07/08/2007

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