Provider Demographics
NPI:1851803795
Name:QUINTIN, DAWN MARIE (MSED)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:QUINTIN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 AMAZON RD
Mailing Address - Street 2:
Mailing Address - City:MOHEGAN LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:10547-1802
Mailing Address - Country:US
Mailing Address - Phone:914-246-0501
Mailing Address - Fax:
Practice Address - Street 1:2 WESTCHESTER PLZ STE 137
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-1607
Practice Address - Country:US
Practice Address - Phone:914-243-0501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist