Provider Demographics
NPI:1669559456
Name:DEOTTE, PATRICIA B (PT, DPT, GCS)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:B
Last Name:DEOTTE
Suffix:
Gender:F
Credentials:PT, DPT, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 WILLIAM PENN RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5046
Mailing Address - Country:US
Mailing Address - Phone:908-647-5524
Mailing Address - Fax:
Practice Address - Street 1:23 WILLIAM PENN RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5046
Practice Address - Country:US
Practice Address - Phone:908-647-5524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA000973002251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ091321Medicare ID - Type Unspecified