Provider Demographics
NPI:1508011255
Name:QUINN WARD, CATHERINE
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:QUINN WARD
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5224 65TH PL
Mailing Address - Street 2:#6M
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-1351
Mailing Address - Country:US
Mailing Address - Phone:718-316-8213
Mailing Address - Fax:
Practice Address - Street 1:5224 65TH PL
Practice Address - Street 2:#6M
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-1351
Practice Address - Country:US
Practice Address - Phone:718-316-8213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010578-1225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist