Provider Demographics
NPI:1528195336
Name:RUTLEDGE, PATRICIA MARGARET (OT)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MARGARET
Last Name:RUTLEDGE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BONNIE LN
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-5914
Mailing Address - Country:US
Mailing Address - Phone:516-798-8131
Mailing Address - Fax:516-882-0470
Practice Address - Street 1:16 BONNIE LN
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5914
Practice Address - Country:US
Practice Address - Phone:516-798-8131
Practice Address - Fax:516-882-0470
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011637225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist