Provider Demographics
NPI:1821232604
Name:MCENTIRE, ROBERT PATRICK (DPT)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PATRICK
Last Name:MCENTIRE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 MAMARONECK AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-5224
Mailing Address - Country:US
Mailing Address - Phone:888-830-4125
Mailing Address - Fax:
Practice Address - Street 1:2770 HOOPER AVE # 16
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4160
Practice Address - Country:US
Practice Address - Phone:732-714-5061
Practice Address - Fax:732-714-5062
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021368225100000X
NJ40QA01867100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist