Individual provider Active NPI

Erin M Quinn, PTA

  • Physical Therapy Assistant
  • West Orange, NJ
National Provider Identifier
1033455936
Registry record updated Dec 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
40QB00291000 Issued in NJ
Practice address
622 Eagle Rock Ave
West Orange, NJ 07052-2994
Phone
(973) 669-0078
Fax
(973) 669-1113
NPI assigned
Dec 20, 2012
Last updated
Dec 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 40QB00291000 NJ Primary

Addresses

Primary practice location

622 Eagle Rock Ave
West Orange, NJ 07052-2994

Mailing address

622 Eagle Rock Ave
West Orange, NJ 07052-2994
Phone (973) 669-0078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
40QB00291000NJMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355961600000",
    "number": "1033455936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 EAGLE ROCK AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522994",
            "telephone_number": "973-669-0078",
            "fax_number": "973-669-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 EAGLE ROCK AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522994",
            "telephone_number": "973-669-0078",
            "fax_number": "973-669-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "ERIN",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-20",
        "last_updated": "2012-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00291000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.