Provider Demographics
NPI:1710976949
Name:QUINN, CHRISTOPHER J (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:QUINN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 ROUTE 1 S
Mailing Address - Street 2:BLDG A
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-3009
Mailing Address - Country:US
Mailing Address - Phone:732-750-0400
Mailing Address - Fax:732-750-1507
Practice Address - Street 1:485 ROUTE 1
Practice Address - Street 2:BLDG A
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-3009
Practice Address - Country:US
Practice Address - Phone:732-750-0400
Practice Address - Fax:732-750-1507
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJZ70A00466000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1095501Medicaid
NJ478600MP7Medicare ID - Type Unspecified
U26783Medicare UPIN