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General NPI Number Information
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NPI Number | 1295662443
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Entity Type | Individual
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Provider Name | SEBASTIAN SEMBOS QUIANA
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Gender | Male
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Dates
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Enumeration Date | 05/04/2026
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Last Update Date | 05/04/2026
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Provider Practice Location Address
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Address Line | 401 BROADWAY
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City | CAMDEN
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State | NJ
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Zip | 08103-1211
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Country | US
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Telephone | 856-361-2850
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Fax |
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Provider Business Mailing Address
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Address Line | 1208 PICCARD CT
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City | DEPTFORD
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State | NJ
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Zip | 08096-5124
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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