Provider Demographics
NPI:1083913057
Name:ARNOTT, PATRICIA ELLEN (PTA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ELLEN
Last Name:ARNOTT
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 1:34 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCK TAVERN
Mailing Address - State:NY
Mailing Address - Zip Code:12575-5007
Mailing Address - Country:US
Mailing Address - Phone:845-567-6787
Mailing Address - Fax:
Practice Address - Street 1:34 MAPLE AVE.
Practice Address - Street 2:
Practice Address - City:ROCK TAVERN
Practice Address - State:NY
Practice Address - Zip Code:12575
Practice Address - Country:US
Practice Address - Phone:845-457-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000930-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000930-1Medicaid