Healthcare Provider Details

I. General information

NPI: 1104053610
Provider Name (Legal Business Name): ADRIANNE O'QUINN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ADRIANNE MONACO MD

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 05/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7449 MORGAN RD BUILDING 2
LIVERPOOL NY
13090-3973
US

IV. Provider business mailing address

7449 MORGAN RD BUILDING 2
LIVERPOOL NY
13090-3973
US

V. Phone/Fax

Practice location:
  • Phone: 315-451-5400
  • Fax:
Mailing address:
  • Phone: 315-451-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number2586171
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number2586171
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: