Provider Demographics
NPI:1699701706
Name:QUINLAN, DENNIS PHILIP SR (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:PHILIP
Last Name:QUINLAN
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:231 WARWICK AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-2442
Mailing Address - Country:US
Mailing Address - Phone:973-763-6384
Mailing Address - Fax:973-763-6173
Practice Address - Street 1:90 BERGEN ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2425
Practice Address - Country:US
Practice Address - Phone:973-972-2500
Practice Address - Fax:973-972-2510
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02411500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2238501Medicaid
NJ2238501Medicaid
NJE44148Medicare UPIN