Provider Demographics
NPI:1457032419
Name:QUINTA PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:QUINTA PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIETHER PAUL
Authorized Official - Middle Name:OFARIL
Authorized Official - Last Name:QUINTANA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:956-539-9631
Mailing Address - Street 1:3275 44TH ST APT 1R
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-2312
Mailing Address - Country:US
Mailing Address - Phone:956-539-9631
Mailing Address - Fax:929-249-5576
Practice Address - Street 1:13668 ROOSEVELT AVE STE 5C
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5510
Practice Address - Country:US
Practice Address - Phone:956-539-9631
Practice Address - Fax:929-249-5576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty