Organization
PARENTS BABY TRIAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE QUAN MD (MANAGING MEMBER)
(914) 733-2505
Entity
Organization
Contact information
Practice address
1 TRANQUILITY CT, HOLMDEL, NJ 07733-2413
(917) 733-2505
Mailing address
1 TRANQUILITY CT, HOLMDEL, NJ 07733-2413
(917) 733-2505
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA11429500
NJ STATE LICENSE
NJ
Enumeration date
08/08/2022
Last updated
08/08/2022
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