Healthcare Provider Details

I. General information

NPI: 1295280006
Provider Name (Legal Business Name): SARA QUINTEROS MBA, MS, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2016
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 W LOMBARD ST STE 195
BALTIMORE MD
21201-1009
US

IV. Provider business mailing address

737 W LOMBARD ST STE 195
BALTIMORE MD
21201-1009
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-5484
  • Fax:
Mailing address:
  • Phone: 410-328-5484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: