Provider Demographics
NPI:1801142575
Name:QUINTERO, JUVIE GUEVARA (REGISTERED PHYSICAL)
Entity type:Individual
Prefix:
First Name:JUVIE
Middle Name:GUEVARA
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:REGISTERED PHYSICAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2676 GRAND CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458
Mailing Address - Country:US
Mailing Address - Phone:718-733-1000
Mailing Address - Fax:718-733-0351
Practice Address - Street 1:2676 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458
Practice Address - Country:US
Practice Address - Phone:718-733-1000
Practice Address - Fax:718-733-0351
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02430-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist