Patrick A McKenzie, PT
Individual provider Active NPI Physical Therapist · Harrington, DE
NPI 1801975388 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801975388
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- J10000499 (DE)
- Practice address
- 610 Gordon St
Harrington, DE 19952-1217 - Phone
- (410) 822-4613
- Fax
- (410) 822-6534
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J10000499 | DE | MD | Physical Therapist |
| 19521 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| W James Downs Jr PT PA | Past | Accepting new patients | |
| Tidewater Physical Therapy and Rehabilitation Associates, P.a. | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | J10000499 | DE | Yes |
| Physical Therapist | 225100000X | 19521 | MD |
Addresses
Primary practice location
610 Gordon St
Harrington, DE 19952-1217
Mailing address
11 E Saratoga Rd
Milford, DE 19963-2107
Phone (410) 822-4613
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000220726 | Medicaid | DE |
Other providers in Harrington, DE
- Guerdine Michoux Louis
- Alexis Nicole Groce Mackin
- Bolayibo A Mayowa
- Donicha McCann-Cross
- Kelly J McKenzie
- Medical Center of Harrington
- Charles G Miriello
- Helen Mittnight
- Kate Elizabeth Moore
- Andrew Nash
All providers in Harrington, DE · Physical Therapist in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.