Provider Demographics
NPI:1740033638
Name:PORTER, QUADEER LAMAR
Entity type:Individual
Prefix:MR
First Name:QUADEER
Middle Name:LAMAR
Last Name:PORTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 S ORANGE AVE # 2240
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-1342
Mailing Address - Country:US
Mailing Address - Phone:973-434-5081
Mailing Address - Fax:
Practice Address - Street 1:78 CUTLER ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-2533
Practice Address - Country:US
Practice Address - Phone:973-991-7849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical