Provider Demographics
NPI:1649592544
Name:QUINN, ALICE THERESA (ALICE QUINN RN)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:THERESA
Last Name:QUINN
Suffix:
Gender:F
Credentials:ALICE QUINN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 VILLAGE GRN
Mailing Address - Street 2:
Mailing Address - City:BARDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2035
Mailing Address - Country:US
Mailing Address - Phone:845-624-4342
Mailing Address - Fax:
Practice Address - Street 1:590 AVENUES OF THE AMERICANS
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:646-459-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY361097-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool