Provider Demographics
NPI:1225246614
Name:QUIJANO, CHARMAINE A (PT)
Entity Type:Individual
Prefix:
First Name:CHARMAINE
Middle Name:A
Last Name:QUIJANO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LIU CTR FOR PHYSICAL REHAB 1 UNIVERSITY PLAZA, HS-204
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201
Mailing Address - Country:US
Mailing Address - Phone:718-780-4532
Mailing Address - Fax:718-780-4524
Practice Address - Street 1:1 UNIVERSITY PLZ # HS-204
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5301
Practice Address - Country:US
Practice Address - Phone:718-780-4532
Practice Address - Fax:718-780-4524
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0163182251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic