Doctor Name: | MRS. PATRICIA ANNE EDWARDS |
NPI Number: | 1407153067 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ANP |
License Number: | F303772 |
Business Practice Address: | 30 Bell Avenue Brookhaven National Laboratory, Omc, Bldg. 490 Upton, NY - 119735000 |
Business Phone Number: | 6313443670 |
Business Fax Number: | 6313447366 |
Mailing Address: | 37 Harvard Ln, COMMACK |
State: | NY |
Postal Code: | 117252527 |
Phone Number: | 6313443670 |
Fax Number: | 6313447366 |
NPI Enumeration Date: | 02/17/2011 |
NPI Last Update Date: | 02/17/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | F303772 |
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: |