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General NPI Number Information
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NPI Number | 1174524151
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Entity Type | Individual
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Provider Name | KATHRYN J QUINN MD
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Gender | Female
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 04/22/2013
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Provider Practice Location Address
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Address Line | 3180 MAIN ST SUITE G-1
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City | BRIDGEPORT
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State | CT
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Zip | 06606-4237
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Country | US
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Telephone | 203-371-7111
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Fax | 203-372-5636
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Provider Business Mailing Address
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Address Line | 1817 BLACK ROCK TPKE
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City | FAIRFIELD
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State | CT
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Zip | 06825-3546
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Country | US
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Telephone | 203-371-7111
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Fax | 203-372-5636
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 042121
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License Number State | CT
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