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NPI Code Detail

MEDICARE: MR. GREGORY P QUARTANO LCSW

MEDICARE: MR. GREGORY P QUARTANO LCSW
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
11041C0700XClinical Social Worker3829LA

General Provider Information

NPI Number : 1457370801
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GREGORY P QUARTANO LCSW
Provider Business Mailing Address
First Line : PO BOX 1725
Second Line :
City : GONZALES
State : LA
Zip : 70707-1725
Country : US
Telephone Number : 225-621-5770
Fax Number : 225-644-3208
Provider Business Practice Location Address
First Line : 1112 E ASCENSION COMPLEX BLVD
Second Line :
City : GONZALES
State : LA
Zip : 70737-4265
Country : US
Telephone Number : 225-621-5770
Fax Number : 225-644-3208
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 07/08/2007

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