Provider Demographics
NPI:1487046256
Name:DIQUINZIO, ATALIA (PTA)
Entity type:Individual
Prefix:
First Name:ATALIA
Middle Name:
Last Name:DIQUINZIO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1598 S MICHIGAN WAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-4546
Mailing Address - Country:US
Mailing Address - Phone:720-989-8183
Mailing Address - Fax:
Practice Address - Street 1:333 S EATON ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3544
Practice Address - Country:US
Practice Address - Phone:303-935-1448
Practice Address - Fax:303-935-1440
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013529225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO066646Medicare PIN