Provider Demographics
NPI:1417187113
Name:ELMEN, PATRICIA R (OTR)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:R
Last Name:ELMEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-2502
Mailing Address - Country:US
Mailing Address - Phone:518-793-9465
Mailing Address - Fax:
Practice Address - Street 1:112 SKI BOWL RD
Practice Address - Street 2:
Practice Address - City:NORTH CREEK
Practice Address - State:NY
Practice Address - Zip Code:12853-2607
Practice Address - Country:US
Practice Address - Phone:518-251-2447
Practice Address - Fax:518-251-5539
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006427225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist