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General NPI Number Information
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NPI Number | 1548682867
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Entity Type | Individual
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Provider Name | STACY F PATTEN DPT
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Gender | Female
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Dates
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Enumeration Date | 01/07/2014
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Last Update Date | 02/27/2019
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Provider Practice Location Address
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Address Line | 46 LONG POND RD
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City | PLYMOUTH
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State | MA
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Zip | 02360-2606
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Country | US
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Telephone | 774-283-4387
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Fax |
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Provider Business Mailing Address
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Address Line | 576 BROADHOLLOW RD
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City | MELVILLE
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State | NY
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Zip | 11747-5002
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Country | US
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Telephone | 631-359-5859
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Fax | 631-396-0865
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 20905
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License Number State | MA
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