Provider Demographics
NPI:1205236007
Name:CLAYPOOLE NINOS, PATRICIA
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:CLAYPOOLE NINOS
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 1:1133 WYNNEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18067-8711
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1133 WYNNEWOOD DR
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18067-8711
Practice Address - Country:US
Practice Address - Phone:610-393-7980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001753E2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics