| Doctor Name: | INGRID GORDON-PATTERSON |
| NPI Number: | 1275765661 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 305202 |
| Business Practice Address: | 400 Horseblock Rd Ste H Farmingville, NY - 117381252 |
| Business Phone Number: | 6314512211 |
| Business Fax Number: | 6314511463 |
| Mailing Address: | 400 Horseblock Rd, Ste H FARMINGVILLE |
| State: | NY |
| Postal Code: | 117381252 |
| Phone Number: | 6314512211 |
| Fax Number: | 6314511463 |
| NPI Enumeration Date: | 08/18/2009 |
| NPI Last Update Date: | 10/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 305202 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |