Provider Demographics
NPI:1528044013
Name:QUINN, JOHN PAUL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:QUINN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MANCHESTER RD
Mailing Address - Street 2:SUITE101
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2586
Mailing Address - Country:US
Mailing Address - Phone:845-454-4137
Mailing Address - Fax:845-454-6457
Practice Address - Street 1:2310 BALE ST STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27608-1795
Practice Address - Country:US
Practice Address - Phone:919-364-4000
Practice Address - Fax:919-746-9229
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0269451225100000X
NCP17475225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10107038OtherCDPHP
NY796654OtherMVP
NY406936OtherWELLCARE
NY116413OtherGHI
NY692546OtherEMPIRE MPN
NYQ30Z210Medicare PIN