Provider Demographics
NPI:1740546803
Name:FILASTO, PATRICIA ANN (MSED)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:FILASTO
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SENTRY PL APT 1D
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-2514
Mailing Address - Country:US
Mailing Address - Phone:914-725-3236
Mailing Address - Fax:
Practice Address - Street 1:5 SENTRY PL APT 1D
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-2514
Practice Address - Country:US
Practice Address - Phone:914-725-3236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189808021174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist