Provider Demographics
NPI:1992715825
Name:QUINONES, ARIEL (MD)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:QUINONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 ELMORA AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-2248
Mailing Address - Country:US
Mailing Address - Phone:908-576-8982
Mailing Address - Fax:908-576-8985
Practice Address - Street 1:38 ELMORA AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-2248
Practice Address - Country:US
Practice Address - Phone:908-576-8982
Practice Address - Fax:908-576-8985
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA64706207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8042004Medicaid
NJ223678339OtherFEDERAL TAX IDENTIFICATION NUMBER
NJ016641Medicare ID - Type Unspecified
NJ8042004Medicaid