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Organization
PAUL R. QUINTAVALLE
Active
Organization
PAUL R. QUINTAVALLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL R. QUINTAVALLE DPM (OWNER)
(856) 858-0180
Entity
Organization
Contact information
Practice address
879 HADDON AVE, COLLINGSWOOD, NJ 08108-1941
(856) 858-0180
(858) 869-3080
Mailing address
879 HADDON AVE, COLLINGSWOOD, NJ 08108-1941
(856) 858-0180
(858) 869-3080
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
MD00105600
NJ
213ES0103X
Foot & Ankle Surgery Podiatrist
MD00105600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1735501
—
NJ
Enumeration date
11/01/2016
Last updated
11/01/2016
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