Provider Demographics
NPI:1548150394
Name:QUINTON, SHANNON LYNDA (ATC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:LYNDA
Last Name:QUINTON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-6251
Mailing Address - Country:US
Mailing Address - Phone:516-640-7309
Mailing Address - Fax:
Practice Address - Street 1:58 GRANT ST
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-6251
Practice Address - Country:US
Practice Address - Phone:516-640-7309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20000583942255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer