Healthcare Provider Details
I. General information
NPI: 1952097354
Provider Name (Legal Business Name): ALEXANDRIA JEAN QUINERE
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/18/2023
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
433 HACKENSACK AVE
HACKENSACK NJ
07601-6319
US
IV. Provider business mailing address
3 UNIVERSITY PLZ STE 205
HACKENSACK NJ
07601-6208
US
V. Phone/Fax
- Phone: 201-837-3200
- Fax: 201-837-8993
- Phone: 201-833-3599
- Fax: 201-227-6207
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 25MB13059000 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: