Individual provider Active NPI

Mary Theresa Quinn, PT

  • Physical Therapist
  • Glenwood Landing, NY
National Provider Identifier
1386620219
Registry record updated Mar 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10709 Issued in NY
Practice address
136 Glenwood Rd
Glenwood Landing, NY 11547-0274
Phone
(516) 676-1445
Fax
(516) 676-1449
NPI assigned
Dec 22, 2005
Last updated
Mar 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 10709 NY
Physical Therapist 225100000X 10709 NY Primary

Addresses

Primary practice location

136 Glenwood Rd
Glenwood Landing, NY 11547-0274

Mailing address

PO Box 274
Glenwood Landing, NY 11547-0274
Phone (516) 628-2008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10709NYMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Past Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458950400000",
    "number": "1386620219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 274",
            "city": "GLENWOOD LANDING",
            "state": "NY",
            "postal_code": "115470274",
            "telephone_number": "516-628-2008",
            "fax_number": "516-676-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 GLENWOOD RD",
            "city": "GLENWOOD LANDING",
            "state": "NY",
            "postal_code": "115470274",
            "telephone_number": "516-676-1445",
            "fax_number": "516-676-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "MARY",
        "middle_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2016-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "10709",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "10709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood Landing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.