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General NPI Number Information
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NPI Number | 1750936571
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Entity Type | Individual
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Provider Name | MARIVXY QUINTEROS
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Gender | Female
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Dates
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Enumeration Date | 08/08/2019
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 966 PROSPECT AVE
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City | BRONX
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State | NY
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Zip | 10459-3270
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Country | US
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Telephone | 718-842-1412
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Fax | 718-947-2257
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Provider Business Mailing Address
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Address Line | 311 EAST 175TH STREER
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City | BRONX
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State | NY
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Zip | 10457-2536
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Country | US
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Telephone | 718-960-7522
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Fax | 718-583-6439
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F406190
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License Number State | NY
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