Provider Demographics
NPI:1639225741
Name:QUINN, TERRENCE M (RPH)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:M
Last Name:QUINN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 DEKALB ST
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-5412
Mailing Address - Country:US
Mailing Address - Phone:716-693-2707
Mailing Address - Fax:
Practice Address - Street 1:4407 MILITARY RD
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14305-1333
Practice Address - Country:US
Practice Address - Phone:716-297-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030294183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist