MEDICARE: DIANA VANESSA QUINTERO DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	050997	NY

General Provider Information

NPI Number	:	1962285726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA VANESSA QUINTERO DPT

Provider Business Mailing Address
First Line	:	2649 STRANG BLVD STE 304
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-2938
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7206 NORTHERN BLVD FL 2
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-1049
Country	:	US
Telephone Number	:	844-734-2201
Fax Number	:	718-533-1772

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2023
Last Update Date	:	02/10/2026

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