Provider Demographics
NPI:1548774144
Name:PATTI, ROSARIO MICHAEL (DPT)
Entity Type:Individual
Prefix:
First Name:ROSARIO
Middle Name:MICHAEL
Last Name:PATTI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10710 CHARTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3260
Mailing Address - Country:US
Mailing Address - Phone:410-644-1880
Mailing Address - Fax:410-730-1617
Practice Address - Street 1:10710 CHARTER DR STE 300
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3260
Practice Address - Country:US
Practice Address - Phone:410-644-1880
Practice Address - Fax:410-730-1617
Is Sole Proprietor?:No
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26790225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist