Most Relevant Information
Provider Data
| NPI Number: | 1003259573 |
| Provider Name: | STACEY ANNE QUINTANILLA M.A. |
| Entity Type: | Individual |
| Taxonomy Code: | 174H00000X |
| Specialty: | Health Educator |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/15/2013 |
| Last Updated: | 04/15/2013 |
Provider Practice Location
35 LONGWOOD RD
MIDDLE ISLAND
NY
119532045
Practice Location Phone/Fax
| Phone: | 6319240008 |
| Fax: | 6319244602 |
Provider Mailing Location
PO BOX 12
MIDDLE ISLAND
NY
119530012
Provider Mailing Phone/Fax
| Phone: | 6319240008 |
| Fax: | 6319244602 |