Provider Demographics
NPI:1154596039
Name:QUINN, JAIME
Entity type:Individual
Prefix:
First Name:JAIME
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 1:420 LEXINGTON AVE LBBY 4
Mailing Address - Street 2:C/O EQUINOX
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10170-0024
Mailing Address - Country:US
Mailing Address - Phone:212-973-0655
Mailing Address - Fax:212-973-0656
Practice Address - Street 1:420 LEXINGTON AVE LBBY 4
Practice Address - Street 2:C/O EQUINOX
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10170-0024
Practice Address - Country:US
Practice Address - Phone:212-973-0655
Practice Address - Fax:212-973-0656
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30122225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist