Provider Demographics
NPI:1992538391
Name:QUINN, PETER ANDREW (DPT)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:ANDREW
Last Name:QUINN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 ROUTE 34
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1808
Mailing Address - Country:US
Mailing Address - Phone:732-612-9948
Mailing Address - Fax:732-529-2866
Practice Address - Street 1:2440 ROUTE 34
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1808
Practice Address - Country:US
Practice Address - Phone:732-612-9948
Practice Address - Fax:732-529-2866
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02274500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist