Provider Demographics
NPI:1043466063
Name:NGAFOOK, PATRICK MT (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:MT
Last Name:NGAFOOK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2020
Mailing Address - Country:US
Mailing Address - Phone:516-384-8855
Mailing Address - Fax:
Practice Address - Street 1:24 W 57TH ST
Practice Address - Street 2:SUITE #507
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3918
Practice Address - Country:US
Practice Address - Phone:212-421-3418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054055122300000X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist