Provider Demographics
NPI:1619995636
Name:QUINBY, ROBERT (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:QUINBY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8500-6355
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-612-4532
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-612-4963
Practice Address - Fax:215-612-4532
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008430L207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017053870002Medicaid
PA020038580OtherRAILROAD MEDICARE
PA07645OtherHEALTH PARTNERS
PA879238OtherPERSONAL CHOICE
PA20040754OtherAMERIHEALTH MERCY
PA0017053870001Medicaid
PA0080870000OtherKEYSTONE IBC
PA879238OtherHIGHMARK BLUE SHIELD
PA0017053870006Medicaid
PA01705387-02OtherAMERICHOICE- TORRESDALE
PA1111370OtherKEYSTONE MERCY
PA452729OtherAETNA CONTRACT
PA6092987OtherCIGNA
PA0017053870001Medicaid
PA6092987OtherCIGNA