Provider Demographics
NPI:1124178991
Name:VERDOTE, PATRICIA U
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:U
Last Name:VERDOTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 E GATE ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE FERRY
Mailing Address - State:NJ
Mailing Address - Zip Code:07643-1053
Mailing Address - Country:US
Mailing Address - Phone:201-983-0404
Mailing Address - Fax:
Practice Address - Street 1:205 ROBIN RD
Practice Address - Street 2:SUITE 118
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1449
Practice Address - Country:US
Practice Address - Phone:201-225-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01227400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist