Healthcare Provider Details

I. General information

NPI: 1265342448
Provider Name (Legal Business Name): JULIA QUANTZ PMHNP
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

177 FORT WASHINGTON AVE
NEW YORK NY
10032-3733
US

IV. Provider business mailing address

177 FORT WASHINGTON AVE
NEW YORK NY
10032-3733
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-2565
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number409223
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: