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NPI Code Detail

MEDICARE: STIVALY RODRIGUEZ QUEZADA MD

MEDICARE: STIVALY RODRIGUEZ QUEZADA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician1014721MA

General Provider Information

NPI Number : 1215500111
Entity Type Code : Individual
Provider Name (Legal Business Name) : STIVALY RODRIGUEZ QUEZADA MD
Provider Business Mailing Address
First Line : 380R MERRIMACK ST STE 3B
Second Line :
City : METHUEN
State : MA
Zip : 01844-5884
Country : US
Telephone Number : 978-687-6355
Fax Number :
Provider Business Practice Location Address
First Line : 380R MERRIMACK ST STE 3B
Second Line :
City : METHUEN
State : MA
Zip : 01844-5884
Country : US
Telephone Number : 978-687-6355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2021
Last Update Date : 03/18/2026

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