Healthcare Provider Details

I. General information

NPI: 1962330944
Provider Name (Legal Business Name): CARMEN ELIANA QUINTERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10509 METROPOLITAN AVE STE 1
FOREST HILLS NY
11375-6737
US

IV. Provider business mailing address

8472 130TH ST
KEW GARDENS NY
11415-2808
US

V. Phone/Fax

Practice location:
  • Phone: 718-350-0816
  • Fax:
Mailing address:
  • Phone: 718-350-0816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number007838-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: