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General NPI Number Information
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NPI Number | 1417249350
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Entity Type | Organization
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Legal Business Name | Q HOLDINGS LLC
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Dates
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Enumeration Date | 05/11/2011
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Last Update Date | 09/05/2014
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Provider Practice Location Address
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Address Line | 12 GARDEN ST
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City | RHINEBECK
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State | NY
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Zip | 12572-1357
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Country | US
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Telephone | 845-876-2433
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Fax |
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Provider Business Mailing Address
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Address Line | 12 GARDEN ST
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City | RHINEBECK
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State | NY
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Zip | 12572-1357
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Country | US
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Telephone | 845-876-2433
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JAVIER G QUINERO-CHICA
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Credential | OD
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Telephone | 845-876-2433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T005366-1
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License Number State | NY
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