Healthcare Provider Details

I. General information

NPI: 1821064015
Provider Name (Legal Business Name): ANDREW R QUINT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 06/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4510 FRANKFORD AVE
PHILADELPHIA PA
19124-3602
US

IV. Provider business mailing address

432 N 6TH ST
PHILADELPHIA PA
19123-4004
US

V. Phone/Fax

Practice location:
  • Phone: 215-744-1302
  • Fax: 215-744-2544
Mailing address:
  • Phone: 215-925-2400
  • Fax: 215-925-9162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD029058E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: