Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 25MD00168300 | NJ |
NPI | 1568528875 |
---|---|
Provider Name | Christine M Quinn |
First Address | Basking Ridge, NJ 07920 |
Second Address | Basking Ridge, NJ 07920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2006 |
Last Update Date | 09/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T45541 | (02) | NJ |