Provider Demographics
NPI:1073682118
Name:PATE, JULIE ANN (RPA-C)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:PATE
Suffix:
Gender:F
Credentials:RPA-C
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Mailing Address - Street 1:PO BOX 29234
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-9234
Mailing Address - Country:US
Mailing Address - Phone:631-329-6925
Mailing Address - Fax:631-329-6951
Practice Address - Street 1:535 E 70TH ST
Practice Address - Street 2:6TH FLOOR, STE 637
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4823
Practice Address - Country:US
Practice Address - Phone:646-797-8713
Practice Address - Fax:646-797-8777
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2021-04-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY006454363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03842362Medicaid
NYA400035382Medicare PIN