Provider Demographics
NPI:1952349201
Name:PATRINOSTRO, JING C (MD)
Entity Type:Individual
Prefix:
First Name:JING
Middle Name:C
Last Name:PATRINOSTRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3653
Mailing Address - Country:US
Mailing Address - Phone:508-862-5504
Mailing Address - Fax:508-790-3304
Practice Address - Street 1:460 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3653
Practice Address - Country:US
Practice Address - Phone:508-862-5504
Practice Address - Fax:508-790-3304
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2237082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
I33062Medicare UPIN
MAA3855901Medicare PIN