Provider Demographics
NPI:1871671347
Name:QUINN, JEANETTE T (PT)
Entity Type:Individual
Prefix:MISS
First Name:JEANETTE
Middle Name:T
Last Name:QUINN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 INDIAN MILLS RD
Mailing Address - Street 2:
Mailing Address - City:SHAMONG
Mailing Address - State:NJ
Mailing Address - Zip Code:08088-8915
Mailing Address - Country:US
Mailing Address - Phone:609-654-8245
Mailing Address - Fax:
Practice Address - Street 1:1765 SPRINGDALE RD
Practice Address - Street 2:BUILDING A
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2177
Practice Address - Country:US
Practice Address - Phone:856-751-8787
Practice Address - Fax:856-751-0449
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01225000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist