Healthcare Provider Details

I. General information

NPI: 1407066814
Provider Name (Legal Business Name): THOMAS F QUINLAN PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 04/23/2021
Certification Date: 04/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 FREEPORT RD 200 BLGD. SUITE 4000
PITTSBURGH PA
15215-3301
US

IV. Provider business mailing address

625 WALNUT ST
MCKEESPORT PA
15132-2806
US

V. Phone/Fax

Practice location:
  • Phone: 412-784-5010
  • Fax: 421-784-5147
Mailing address:
  • Phone: 412-673-5005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTE005032L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: