Provider Demographics
NPI:1316389935
Name:LADAO-SOTO, QUENNIE M (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:QUENNIE
Middle Name:M
Last Name:LADAO-SOTO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:QUENNIE
Other - Middle Name:M
Other - Last Name:LADAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,DPT
Mailing Address - Street 1:9324 QUEENS BLVD
Mailing Address - Street 2:SUITE 1G
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1147
Mailing Address - Country:US
Mailing Address - Phone:718-730-9040
Mailing Address - Fax:
Practice Address - Street 1:655 PARKSIDE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-1505
Practice Address - Country:US
Practice Address - Phone:718-941-0320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0321142251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist