Individual
AUGUSTO RENE QUEZADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 ALABAMA AVE SE, WASHINGTON, DC 20032-4542
(202) 299-5100
Mailing address
64 NEW YORK AVE NE FL 3, WASHINGTON, DC 20002-3328
(202) 673-2200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2608
DC
225100000X
Physical Therapist
—
—
2251G0304X
Geriatric Physical Therapist
PT2608
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538254016
—
DC
05
—
1871634170
—
DC
Enumeration date
07/08/2022
Last updated
07/08/2022
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