Healthcare Provider Details

I. General information

NPI: 1427031533
Provider Name (Legal Business Name): MARGARET MARY QUINN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 STATE ROUTE 33 JERSEY SHORE UNIVERSITY MEDICAL CENTER
NEPTUNE NJ
07753-4859
US

IV. Provider business mailing address

10 PHILADELPHIA AVE
LAVALLETTE NJ
08735-2344
US

V. Phone/Fax

Practice location:
  • Phone: 732-897-7846
  • Fax: 732-897-7200
Mailing address:
  • Phone: 732-897-7846
  • Fax: 732-897-7200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA39903
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: