Individual
ELLORA BERTHET QUINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9010 LORTON STATION BLVD STE 100, LORTON, VA 22079-4796
(703) 436-1200
Mailing address
3401 CIVIC CENTER BLVD RM 9NW55, PHILADELPHIA, PA 19104-4319
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101269623
VA
208000000X
Pediatrics Physician
MT213229
PA
Other
Enumeration date
06/02/2017
Last updated
05/27/2021
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