Healthcare Provider Details

I. General information

NPI: 1437595261
Provider Name (Legal Business Name): LORI QUINTAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 S CARROLLTON AVE
NEW ORLEANS LA
70118-4307
US

IV. Provider business mailing address

3201 S CARROLLTON AVE
NEW ORLEANS LA
70118-4307
US

V. Phone/Fax

Practice location:
  • Phone: 504-207-3060
  • Fax: 504-207-3067
Mailing address:
  • Phone: 504-207-3060
  • Fax: 504-207-3067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD206473
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberQ5908
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: