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General NPI Number Information
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NPI Number | 1013699651
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Entity Type | Organization
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Legal Business Name | QUADRANT RI VIRTUAL CARE P.C.
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Dates
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Enumeration Date | 08/03/2023
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 10 DORRANCE ST STE 700
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City | PROVIDENCE
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State | RI
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Zip | 02903-2014
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Country | US
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Telephone | 866-219-8595
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Fax |
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Provider Business Mailing Address
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Address Line | 841 E FAYETTE ST
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City | SYRACUSE
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State | NY
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Zip | 13210-1521
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRACY BURTON
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Credential |
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Telephone | 315-234-0103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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