Provider Demographics
NPI:1659333607
Name:PATTERSON, CAROL ANNE (PT OCS CHT)
Entity Type:Individual
Prefix:
First Name:CAROL ANNE
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:PT OCS CHT
Other - Prefix:
Other - First Name:CAROL ANNE
Other - Middle Name:
Other - Last Name:SEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 NORTH AVE E
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2441
Mailing Address - Country:US
Mailing Address - Phone:908-276-0237
Mailing Address - Fax:908-276-5692
Practice Address - Street 1:210 NORTH AVE E
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2441
Practice Address - Country:US
Practice Address - Phone:908-276-0237
Practice Address - Fax:908-276-5692
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA06577225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ043104Medicare ID - Type Unspecified