Healthcare Provider Details

I. General information

NPI: 1538966221
Provider Name (Legal Business Name): LILIAN DOWNEY PATTENGILL
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 N DITHRIDGE ST APT 514
PITTSBURGH PA
15213-2616
US

IV. Provider business mailing address

144 N DITHRIDGE ST APT 514
PITTSBURGH PA
15213-2616
US

V. Phone/Fax

Practice location:
  • Phone: 619-993-8304
  • Fax:
Mailing address:
  • Phone: 619-993-8304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT008820
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberE3760614
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: