MEDICARE: DR. CATHERINE QUINN-KERINS PHD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PS00408-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1881751485	OTHER	PA	AETNA, INDEPENDENCE BC/BS, KEYSTONE, PERSONAL CHOICE, HIGHMARK, UBH, BEACON

General Provider Information

NPI Number	:	1881751485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHERINE QUINN-KERINS PHD LLC

Provider Business Mailing Address
First Line	:	2960 W GERMANTOWN PIKE
Second Line	:	SUITE A
City	:	NORRISTOWN
State	:	PA
Zip	:	19403-1037
Country	:	US
Telephone Number	:	610-631-9298
Fax Number	:	610-631-5282

Provider Business Practice Location Address
First Line	:	2960 W GERMANTOWN PIKE
Second Line	:	SUITE A
City	:	NORRISTOWN
State	:	PA
Zip	:	19403-1037
Country	:	US
Telephone Number	:	610-631-9298
Fax Number	:	610-631-5282

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	05/09/2019

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