Basic Information
| Provider Information | |||||||||
| NPI: | 1699715151 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QUATELA | ||||||||
| FirstName: | VITO | ||||||||
| MiddleName: | CHARLES | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 973 EAST AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146072216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852441000 | ||||||||
| FaxNumber: | 5852714786 | ||||||||
| Practice Location | |||||||||
| Address1: | 973 EAST AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146072216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852441000 | ||||||||
| FaxNumber: | 5852714786 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 02/02/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YX0905X | 147025 | NY | N | Allopathic & Osteopathic Physicians | Otolaryngology | Otolaryngology/Facial Plastic Surgery | 2082S0099X | 147025 | NY | Y | Allopathic & Osteopathic Physicians | Plastic Surgery | Plastic Surgery Within the Head and Neck |
No ID Information.