Basic Information
| Provider Information | |||||||||
| NPI: | 1881659753 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | QUATTRIN | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 MAIN ST FL 5 | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142031009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163230170 | ||||||||
| FaxNumber: | 7163230297 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142031009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163230170 | ||||||||
| FaxNumber: | 7163230297 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2006 | ||||||||
| LastUpdateDate: | 02/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0204X | 178780 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Emergency Medicine | 174400000X | 178780 | NY | Y | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 000510738001 | 01 | BC/BS | OTHER | 0014382920001 | 05 | PA | MEDICAID | 01153662 | 05 | NY | MEDICAID | 040426000978 | 01 | FIDELIS | OTHER | 00010142201 | 01 | UNIVERA | OTHER | 4505798 | 01 | IHA | OTHER |