Provider Demographics
NPI:1093834244
Name:PATT, NURIT HALE (MD)
Entity Type:Individual
Prefix:
First Name:NURIT
Middle Name:HALE
Last Name:PATT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6303 INDIAN SCHOOL RD NE APT 1006
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-8191
Mailing Address - Country:US
Mailing Address - Phone:832-563-6665
Mailing Address - Fax:
Practice Address - Street 1:6303 INDIAN SCHOOL RD NE APT 1006
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-8191
Practice Address - Country:US
Practice Address - Phone:832-563-6665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2007-00662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00SW21Medicare UPIN