Provider Demographics
NPI:1528659448
Name:DANNHEIM, LORI QUINN (PT, EDD)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:QUINN
Last Name:DANNHEIM
Suffix:
Gender:F
Credentials:PT, EDD
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, EDD
Mailing Address - Street 1:182 W 82ND ST APT 3E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5505
Mailing Address - Country:US
Mailing Address - Phone:917-363-7963
Mailing Address - Fax:
Practice Address - Street 1:710 W 168TH ST.
Practice Address - Street 2:NEUROLOGICAL INSTITUTE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:917-363-7963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011984-012251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology