1720169527 NPI number — PATRICIA A PAPE PSYD

Table of content: PATRICIA A PAPE PSYD (NPI 1720169527)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720169527 NPI number — PATRICIA A PAPE PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAPE
Provider First Name:
PATRICIA
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720169527
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
240 1ST AVE
Provider Second Line Business Mailing Address:
#11D
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10009-2601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-329-9650
Provider Business Mailing Address Fax Number:
212-842-0818

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
240 1ST AVE
Provider Second Line Business Practice Location Address:
#11D
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10009-2601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-329-9650
Provider Business Practice Location Address Fax Number:
212-842-0818
Provider Enumeration Date:
10/18/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PY0003532 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 008021 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)