Provider Demographics
NPI:1568528875
Name:QUINN, CHRISTINE M
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:QUINN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 STONEHOUSE ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920
Mailing Address - Country:US
Mailing Address - Phone:908-766-1033
Mailing Address - Fax:908-766-9307
Practice Address - Street 1:41 STONEHOUSE ROAD
Practice Address - Street 2:SUITE102
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920
Practice Address - Country:US
Practice Address - Phone:908-766-1033
Practice Address - Fax:908-766-9307
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00168300213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4440730001Medicare NSC
NJ456945Medicare PIN
NJT45541Medicare UPIN