Healthcare Provider Details

I. General information

NPI: 1447392741
Provider Name (Legal Business Name): SANDRA PATTINATO MED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 INDUSTRIAL PARK RD # A
PLYMOUTH MA
02360-4868
US

IV. Provider business mailing address

28 FOREST ST
CARVER MA
02330-1115
US

V. Phone/Fax

Practice location:
  • Phone: 508-830-1444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: