Provider Demographics
NPI:1972043867
Name:QUINN, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:QUINN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 W 72ND ST
Mailing Address - Street 2:APT 305
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4100
Mailing Address - Country:US
Mailing Address - Phone:201-602-8360
Mailing Address - Fax:
Practice Address - Street 1:20 W 72ND ST
Practice Address - Street 2:APT 305
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4100
Practice Address - Country:US
Practice Address - Phone:201-602-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62 041379225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist