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NPI Code Detail

MEDICARE: TODD ALLAN QUINN LPN

MEDICARE: TODD ALLAN QUINN LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse252120-1NY

General Provider Information

NPI Number : 1508917063
Entity Type Code : Individual
Provider Name (Legal Business Name) : TODD ALLAN QUINN LPN
Provider Business Mailing Address
First Line : 4922 ROUTE 219
Second Line :
City : GREAT VALLEY
State : NY
Zip : 14741-9799
Country : US
Telephone Number : 716-945-6038
Fax Number :
Provider Business Practice Location Address
First Line : 2250 WEHRLE DR
Second Line :
City : WILLIAMSVILLE
State : NY
Zip : 14221-7037
Country : US
Telephone Number : 716-276-2123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2007
Last Update Date : 07/08/2007

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