Provider Demographics
NPI:1407187453
Name:PATO, GREGORY KENNETH (PA)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:KENNETH
Last Name:PATO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 7TH AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6708
Mailing Address - Country:US
Mailing Address - Phone:646-660-9999
Mailing Address - Fax:646-778-3485
Practice Address - Street 1:275 7TH AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6708
Practice Address - Country:US
Practice Address - Phone:646-660-9999
Practice Address - Fax:646-778-3485
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY013782-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical