Healthcare Provider Details

I. General information

NPI: 1720998263
Provider Name (Legal Business Name): GIANNA QUINTANA BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 FAIRFIELD AVE FL 2
BRIDGEPORT CT
06604-4252
US

IV. Provider business mailing address

707 HAWLEY LN UNIT 3
STRATFORD CT
06614-1512
US

V. Phone/Fax

Practice location:
  • Phone: 203-394-6529
  • Fax:
Mailing address:
  • Phone: 203-394-6529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: