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General NPI Number Information
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NPI Number | 1659024131
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Entity Type | Individual
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Provider Name | DANVER QUINTIN OTR/L
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Gender | Male
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Dates
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Enumeration Date | 02/03/2022
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 7 NEWARK POMPTON TPKE
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City | RIVERDALE
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State | NJ
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Zip | 07457-1142
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Country | US
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Telephone | 973-831-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 7 JOSHUA CT
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City | EDISON
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State | NJ
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Zip | 08820-4617
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Country | US
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Telephone | 732-986-1664
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Fax |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 46TR01040100
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License Number State | NJ
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