Provider Demographics
NPI:1285162214
Name:VILLANY, PATRICIA (DPT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:VILLANY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:KYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:15 CHARMER CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-1506
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 ROUTE 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5038
Practice Address - Country:US
Practice Address - Phone:717-451-7870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-03
Last Update Date:2017-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01358300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist