Provider Demographics
NPI:1679509590
Name:MACALTAO, RICHARD PATRICK (MS, PT)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:PATRICK
Last Name:MACALTAO
Suffix:
Gender:M
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 E 58TH ST
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1236
Mailing Address - Country:US
Mailing Address - Phone:212-355-4481
Mailing Address - Fax:212-355-4489
Practice Address - Street 1:133 E 58TH ST
Practice Address - Street 2:SUITE 1001
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1236
Practice Address - Country:US
Practice Address - Phone:212-355-4481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021322-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ11A71Medicare PIN