Provider Demographics
NPI:1093888448
Name:PATLINGRAO, SALVACION A (MD)
Entity Type:Individual
Prefix:
First Name:SALVACION
Middle Name:A
Last Name:PATLINGRAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 AVENUE R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYLN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4334
Mailing Address - Country:US
Mailing Address - Phone:418-692-0038
Mailing Address - Fax:
Practice Address - Street 1:585 SCHENECTADY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-604-5591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY138312207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00478280Medicaid
B12302Medicare UPIN
NY29A351Medicare PIN