Individual
DR. QUINN MALIA OMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
130 E 77TH ST, NEW YORK, NY 10075-1851
(212) 434-2000
Mailing address
130 E 77TH ST, NEW YORK, NY 10075-1851
(516) 562-2303
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
312479
NY
2084N0400X
Neurology Physician
OP61175514
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2016
Last updated
09/09/2022
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