Healthcare Provider Details

I. General information

NPI: 1558519678
Provider Name (Legal Business Name): LARA VALENTINE QUATINETZ D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 08/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CROSS RIVER ROAD FOUR WINDS HOSPITAL
KATONAH NY
10536
US

IV. Provider business mailing address

800 CROSS RIVER ROAD FOUR WINDS HOSPITAL
KATONAH NY
10536
US

V. Phone/Fax

Practice location:
  • Phone: 914-763-8151
  • Fax: 877-810-1175
Mailing address:
  • Phone: 914-763-8151
  • Fax: 877-810-1175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number265959
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number265959
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: