Provider Demographics
NPI:1700959194
Name:PAQUETTE, DENNIS QUENTIN (MPT)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:QUENTIN
Last Name:PAQUETTE
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9420 KEY WEST AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3334
Mailing Address - Country:US
Mailing Address - Phone:301-294-0050
Mailing Address - Fax:301-424-9234
Practice Address - Street 1:2112 F ST NW
Practice Address - Street 2:SUITE 305
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2715
Practice Address - Country:US
Practice Address - Phone:202-912-8481
Practice Address - Fax:202-912-8484
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA2305204223225100000X
DC2532225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCF8710014OtherCAREFIRST BLUE CROSS BLUE SHIELD
DC021167P88Medicare PIN