Quarry St. Internal Medicine, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

QUARRY ST. INTERNAL MEDICINE, LLC

Practice address

90 Quarry St
Willimantic, CT 06226-1225

Phone

(860) 456-2847

Fax

(860) 450-1660

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Andrea L Quintana

Title

Practice Manager

Phone

(860) 456-2847

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366538381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 QUARRY ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062261225",
            "telephone_number": "860-456-2847",
            "fax_number": "860-450-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 QUARRY ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062261225",
            "telephone_number": "860-456-2847",
            "fax_number": "860-450-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUARRY ST. INTERNAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "QUINTANA",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "860-456-2847"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Willimantic, CT
• Providers in Willimantic, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.