Provider Demographics
NPI:1669809182
Name:QUINONES, PATRICIA J (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:J
Last Name:QUINONES
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 JOSEPH CT
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-5015
Mailing Address - Country:US
Mailing Address - Phone:845-662-6892
Mailing Address - Fax:
Practice Address - Street 1:122 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WALDEN
Practice Address - State:NY
Practice Address - Zip Code:12586-1554
Practice Address - Country:US
Practice Address - Phone:845-778-0423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-29
Last Update Date:2013-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004977-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant