Provider Demographics
NPI:1114096849
Name:QUIRK-HALL, DENISE (PNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:QUIRK-HALL
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-2103
Mailing Address - Country:US
Mailing Address - Phone:718-519-4657
Mailing Address - Fax:845-691-8635
Practice Address - Street 1:3424 KOSSUTH AVE
Practice Address - Street 2:1A10
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2410
Practice Address - Country:US
Practice Address - Phone:718-519-4657
Practice Address - Fax:718-519-5001
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF381167363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics