Provider Demographics
NPI:1447056593
Name:QUINAN, EMMANUEL AUGUSTO (PT)
Entity type:Individual
Prefix:MR
First Name:EMMANUEL
Middle Name:AUGUSTO
Last Name:QUINAN
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Gender:
Credentials:PT
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Mailing Address - Street 1:447 FROGTOWN ROAD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:HOGANSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:13655-3136
Mailing Address - Country:US
Mailing Address - Phone:518-358-9778
Mailing Address - Fax:518-358-2043
Practice Address - Street 1:447 FROGTOWN ROAD
Practice Address - Street 2:SUITE 301
Practice Address - City:HOGANSBURG
Practice Address - State:NY
Practice Address - Zip Code:13655-3136
Practice Address - Country:US
Practice Address - Phone:518-358-9778
Practice Address - Fax:518-358-2043
Is Sole Proprietor?:No
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY052008-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist