Provider Demographics
NPI:1174797898
Name:CHRISTINE S. QUINN DPM
Entity type:Organization
Organization Name:CHRISTINE S. QUINN DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-766-1033
Mailing Address - Street 1:15 S FINLEY AVE
Mailing Address - Street 2:PO BOX 73
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-1420
Mailing Address - Country:US
Mailing Address - Phone:908-766-1033
Mailing Address - Fax:908-766-9307
Practice Address - Street 1:15 S FINLEY AVE
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-1420
Practice Address - Country:US
Practice Address - Phone:908-766-1033
Practice Address - Fax:908-766-9307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4440730001Medicare NSC