Provider Demographics
NPI:1992038566
Name:THAUTE, PATTY
Entity Type:Individual
Prefix:
First Name:PATTY
Middle Name:
Last Name:THAUTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 POTOMAC DR
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-3191
Mailing Address - Country:US
Mailing Address - Phone:908-507-6268
Mailing Address - Fax:
Practice Address - Street 1:53 POTOMAC DR
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-3191
Practice Address - Country:US
Practice Address - Phone:908-507-6268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26BT00195600174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist