Provider Demographics
NPI:1578102083
Name:DEPINHO, PATRICIA (RYT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:DEPINHO
Suffix:
Gender:F
Credentials:RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2833
Mailing Address - Country:US
Mailing Address - Phone:516-589-4660
Mailing Address - Fax:
Practice Address - Street 1:623 BROADWAY
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5027
Practice Address - Country:US
Practice Address - Phone:516-781-1078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-31
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner