Provider Demographics
NPI:1548318785
Name:ANDREW S. QUIRK, P.T., P.A.
Entity type:Organization
Organization Name:ANDREW S. QUIRK, P.T., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:S
Authorized Official - Last Name:QUIRK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:973-378-3314
Mailing Address - Street 1:2130 MILLBURN AVE
Mailing Address - Street 2:SUITE C10
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3725
Mailing Address - Country:US
Mailing Address - Phone:973-378-3314
Mailing Address - Fax:
Practice Address - Street 1:2130 MILLBURN AVE
Practice Address - Street 2:SUITE C10
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3725
Practice Address - Country:US
Practice Address - Phone:973-378-3314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00321800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1467525691OtherNPI
NJ40QA00321800OtherNJ STATE PT LICENSE
NJES314OtherOXFORD INSURANCE
NJ0564442OtherAETNA INSURANCE
NJ40QA00321800OtherNJ STATE PT LICENSE