Healthcare Provider Details

I. General information

NPI: 1174797898
Provider Name (Legal Business Name): CHRISTINE S. QUINN DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 S FINLEY AVE
BASKING RIDGE NJ
07920-1420
US

IV. Provider business mailing address

15 S FINLEY AVE PO BOX 73
BASKING RIDGE NJ
07920-1420
US

V. Phone/Fax

Practice location:
  • Phone: 908-766-1033
  • Fax: 908-766-9307
Mailing address:
  • Phone: 908-766-1033
  • Fax: 908-766-9307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE S QUINN
Title or Position: OWNER
Credential:
Phone: 908-766-1033