Individual
CARMELA MAE Q PATRIMONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, PT
Contact information
Practice address
737 COMMACK RD, BRENTWOOD, NY 11717-7407
(631) 388-7500
Mailing address
305 RICHARD AVE, HICKSVILLE, NY 11801-1224
(929) 622-6081
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
045251-01
NY
225200000X
Physical Therapy Assistant
012400-01
NY
Other
Enumeration date
02/12/2022
Last updated
05/10/2023
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