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General NPI Number Information
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NPI Number | 1073669933
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Entity Type | Individual
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Provider Name | MR. ORLANDO JAIME QUIROGA
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Gender | Male
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1901 1ST AVE
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City | NEW YORK
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State | NY
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Zip | 10029-7404
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Country | US
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Telephone | 212-423-8058
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Fax |
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Provider Business Mailing Address
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Address Line | 15038 UNION TPKE APT 11E
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City | FLUSHING
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State | NY
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Zip | 11367-3905
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Country | US
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Telephone | 718-380-0343
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 022379-1
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License Number State | NY
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