Healthcare Provider Details

I. General information

NPI: 1548086515
Provider Name (Legal Business Name): QUANTUM CARE MEDICINE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1636 3RD AVE STE 129
NEW YORK NY
10128-3622
US

IV. Provider business mailing address

1636 3RD AVE STE 129
NEW YORK NY
10128-3622
US

V. Phone/Fax

Practice location:
  • Phone: 646-814-0398
  • Fax:
Mailing address:
  • Phone: 646-814-0398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MAURICE HINSON
Title or Position: OWNER
Credential: MD
Phone: 267-634-7011