Provider Demographics
NPI:1437463627
Name:GORE, PATRICIA ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:GORE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3136 ARNOW PL
Mailing Address - Street 2:APT 4
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4637
Mailing Address - Country:US
Mailing Address - Phone:347-582-2185
Mailing Address - Fax:
Practice Address - Street 1:3136 ARNOW PL
Practice Address - Street 2:APT 4
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4637
Practice Address - Country:US
Practice Address - Phone:347-582-2185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01978912251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics