Basic Information
Provider Information
NPI: 1194782326
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATALINO
FirstName: DAVID
MiddleName: J.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4401 MIDDLE SETTLEMENT RD.
Address2: SUITE 102
City: NEW HARTFORD
State: NY
PostalCode: 13413
CountryCode: US
TelephoneNumber: 3157981700
FaxNumber: 3157981707
Practice Location
Address1: 4401 MIDDLE SETTLEMENT RD STE 102
Address2:  
City: NEW HARTFORD
State: NY
PostalCode: 134135332
CountryCode: US
TelephoneNumber: 3157354496
FaxNumber: 3157981707
Other Information
ProviderEnumerationDate: 05/01/2006
LastUpdateDate: 04/03/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X233471NYY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

ID Information
IDTypeStateIssuerDescription
0259261605NY MEDICAID


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