Provider Demographics
NPI:1659037240
Name:QUINN, JULIA (FMCHC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:QUINN
Suffix:
Gender:F
Credentials:FMCHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HOOVER AVE # 2
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-4247
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 HOOVER AVE # 2
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-4247
Practice Address - Country:US
Practice Address - Phone:818-505-4477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date: