Individual provider · Type 1 NPI

Victor Robert Quintanilla Iv, P.A.

Surgical Physician Assistant · New Haven, CT

NPI number 1114053204 Active

Practice location

1450 Chapel St, Department Of Surgery
New Haven, CT 06511-4405

Call (203) 789-3501 Map

Mailing address

640 Mix Ave, APT#3E
Hamden, CT 06514-2352

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X001468 (CT)

Surgical Physician Assistant: Definition to come...

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About NPI 1114053204

Victor Robert Quintanilla Iv, P.A.'s National Provider Identifier is 1114053204, issued on Feb 26, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in New Haven, CT. The record was last updated on Jul 8, 2007.