Provider Demographics
NPI:1699809780
Name:ARZIC, PATRICIA (RPT)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:ARZIC
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:ARZIC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPT
Mailing Address - Street 1:3717 90TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7868
Mailing Address - Country:US
Mailing Address - Phone:718-505-0707
Mailing Address - Fax:718-505-9199
Practice Address - Street 1:3717 90TH ST FL 1
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7868
Practice Address - Country:US
Practice Address - Phone:718-505-0707
Practice Address - Fax:718-505-9199
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015377-1225100000X, 2251X0800X, 261QP2000X, 2251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02229445Medicaid
NY05556Medicare ID - Type UnspecifiedGHI MEDICARE
NY02229445Medicaid