Provider Demographics
NPI:1821160532
Name:PATINO, CLAUDIA MARIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:MARIA
Last Name:PATINO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9705 HORACE HARDING EXPY
Mailing Address - Street 2:APT 10E
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-4157
Mailing Address - Country:US
Mailing Address - Phone:718-595-1988
Mailing Address - Fax:
Practice Address - Street 1:800 POLY PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7104
Practice Address - Country:US
Practice Address - Phone:718-836-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016907103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02990316Medicaid
NY02990316Medicaid