Provider Demographics
NPI:1831646819
Name:CAVALERI, PATRICIA (PT)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:CAVALERI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 W 173RD ST
Mailing Address - Street 2:APT 5C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1413
Mailing Address - Country:US
Mailing Address - Phone:651-325-7044
Mailing Address - Fax:
Practice Address - Street 1:630 W 173RD ST
Practice Address - Street 2:APT 5C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1413
Practice Address - Country:US
Practice Address - Phone:651-325-7044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040395225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY040395OtherPHYSICAL THERAPY NUMBER