Provider Demographics
NPI:1053319624
Name:QUINN, ANTHONY DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:DENNIS
Last Name:QUINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SHAW'S COVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320
Mailing Address - Country:US
Mailing Address - Phone:860-443-0622
Mailing Address - Fax:860-443-5531
Practice Address - Street 1:3 SHAWS CV
Practice Address - Street 2:SUITE 206
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4952
Practice Address - Country:US
Practice Address - Phone:860-443-0622
Practice Address - Fax:860-443-5531
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT031892174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT340000243Medicare UPIN