| Doctor Name: | PENELOPE M PATSIS |
| NPI Number: | 1164647269 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD. |
| License Number: | 010883 |
| Business Practice Address: | 152 N Wellwood Ave Lindenhurst, NY - 117574046 |
| Business Phone Number: | 6312252465 |
| Business Fax Number: | 6315491797 |
| Mailing Address: | 14 Soundcrest Ln, LLOYD HARBOR |
| State: | NY |
| Postal Code: | 117439790 |
| Phone Number: | 6312252465 |
| Fax Number: | 6315491796 |
| NPI Enumeration Date: | 04/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 010883 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |