Healthcare Provider Details

I. General information

NPI: 1376350223
Provider Name (Legal Business Name): CAITLYN ANN QUARANTA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2024
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2507 SOUTH RD
POUGHKEEPSIE NY
12601-5458
US

IV. Provider business mailing address

29 GRISSOM PL
SALT POINT NY
12578-2024
US

V. Phone/Fax

Practice location:
  • Phone: 845-471-3111
  • Fax:
Mailing address:
  • Phone: 845-242-5727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF350107-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: