Provider Demographics
NPI:1467525691
Name:QUIRK, ANDREW S (PT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:S
Last Name:QUIRK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:37 BURNETT TERRACE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040
Mailing Address - Country:US
Mailing Address - Phone:973-378-8979
Mailing Address - Fax:973-378-3369
Practice Address - Street 1:515 VALLEY ST
Practice Address - Street 2:SUITE 120
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-1388
Practice Address - Country:US
Practice Address - Phone:973-378-3314
Practice Address - Fax:973-378-3369
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00321800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0224501OtherORTHONET
186585OtherUNITED HEALTHCARE
ES314OtherOXFORD
0564442OtherAETNA
186585OtherUNITED HEALTHCARE