Individual
JACQUELYN A QUIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1400 VFW PKWY, WEST ROXBURY, MA 02132
(857) 203-6202
(857) 203-5738
Mailing address
1400 VFW PKWY, MAIL CODE 112, WEST ROXBURY, MA 02132-4927
(857) 203-6202
(857) 203-5757
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
036105475
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
207205
MA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
G78462
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
K9154
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105475
—
IL
Enumeration date
11/09/2005
Last updated
07/31/2018
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