Healthcare Provider Details

I. General information

NPI: 1275876567
Provider Name (Legal Business Name): CHRISTOPHER JUSTIN QUINN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 07/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 GALLOWS RD
FALLS CHURCH VA
22042-3307
US

IV. Provider business mailing address

71 SULLIVAN ST APT 5A
NEW YORK NY
10012-4332
US

V. Phone/Fax

Practice location:
  • Phone: 703-776-4001
  • Fax:
Mailing address:
  • Phone: 917-583-0402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number0101266774
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: