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General NPI Number Information
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NPI Number | 1588319560
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Entity Type | Organization
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Legal Business Name | QUANTUM PHYSICAL THERAPY & CHIROPRACTIC
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 1308 GRAND AVE
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-1418
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Country | US
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Telephone | 516-223-7533
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Fax | 212-888-6024
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Provider Business Mailing Address
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Address Line | 1308 GRAND AVE
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-1418
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Country | US
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Telephone | 516-223-7533
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Fax | 212-888-6024
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Authorized Official
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Title or Position | PHYSICIAN
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Name | JASON T BIRNHAK
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Credential | MD
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Telephone | 516-223-7533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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