Provider Demographics
NPI:1982842944
Name:QUIROS, DEVON (DPT)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:QUIROS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 TRENTON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1622
Mailing Address - Country:US
Mailing Address - Phone:732-429-8296
Mailing Address - Fax:732-497-0528
Practice Address - Street 1:4772 ROUTE 9 S
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3354
Practice Address - Country:US
Practice Address - Phone:732-224-9355
Practice Address - Fax:732-224-1317
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01286600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist