Provider Demographics
NPI:1942726492
Name:PATALINJUG, KEITH ARO (PT)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:ARO
Last Name:PATALINJUG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 WALLACE ST FL 2
Mailing Address - Street 2:
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-3035
Mailing Address - Country:US
Mailing Address - Phone:917-287-5007
Mailing Address - Fax:
Practice Address - Street 1:143 CHARDONNAY DR
Practice Address - Street 2:
Practice Address - City:EAST QUOGUE
Practice Address - State:NY
Practice Address - Zip Code:11942-3829
Practice Address - Country:US
Practice Address - Phone:631-278-0665
Practice Address - Fax:631-619-6680
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist