Organization
CARL G. QUILLEN, M.D. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL G. QUILLEN M.D. (PRESIDENT)
(973) 763-2320
Entity
Organization
Contact information
Practice address
2040 MILLBURN AVE, SUITE 405, MAPLEWOOD, NJ 07040-3726
(973) 763-2320
(973) 763-4648
Mailing address
2040 MILLBURN AVE, SUITE 405, MAPLEWOOD, NJ 07040-3726
(973) 763-2320
(973) 763-4648
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA34002
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6643302
—
NJ
Enumeration date
06/08/2006
Last updated
10/05/2011
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