Active NPI
Brian Patrick Quinn, MS,PTA
- Specialist
- Smithtown, NY
National Provider Identifier
1609089648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 003304
- Practice address
- 240 E Main St
Smithtown, NY 11787-2909 - Phone
- (631) 382-4550
- Fax
- (631) 382-4559
- NPI assigned
- May 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 003304 | NY | Primary |
Addresses
Primary practice location
240 E Main St
Smithtown, NY 11787-2909
Mailing address
3880 Worthmor Dr
Seaford, NY 11783-2011
Phone (516) 221-0055
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003304 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609089648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3880 WORTHMOR DR",
"city": "SEAFORD",
"state": "NY",
"postal_code": "117832011",
"telephone_number": "516-221-0055",
"fax_number": "631-382-4550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 E MAIN ST",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117872909",
"telephone_number": "631-382-4550",
"fax_number": "631-382-4559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUINN",
"first_name": "BRIAN",
"middle_name": "PATRICK",
"name_prefix": "Mr.",
"credential": "MS,PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "003304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.