Healthcare Provider Details

I. General information

NPI: 1356862205
Provider Name (Legal Business Name): MIKHAEL LORENZO CALALANG PATAWARAN PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 07/27/2025
Certification Date: 07/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 N MAIN ST
SPRING VALLEY NY
10977-4020
US

IV. Provider business mailing address

294 CORDIAL RD
YORKTOWN HEIGHTS NY
10598-2604
US

V. Phone/Fax

Practice location:
  • Phone: 845-517-2810
  • Fax:
Mailing address:
  • Phone: 562-253-9632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number041554-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License Number041554
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: