Provider Demographics
NPI:1376665398
Name:QUINN, MICHAEL BRIAN (MED)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:BRIAN
Last Name:QUINN
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 SARGEANT ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-3161
Mailing Address - Country:US
Mailing Address - Phone:413-532-1109
Mailing Address - Fax:
Practice Address - Street 1:425 UNION ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-4115
Practice Address - Country:US
Practice Address - Phone:413-737-4718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional