Provider Demographics
NPI:1144237769
Name:PATTERSON, JOEL R (PA)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:R
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:6255 SHERIDAN DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4836
Mailing Address - Country:US
Mailing Address - Phone:716-857-8666
Mailing Address - Fax:716-857-8994
Practice Address - Street 1:295 ESSJAY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8216
Practice Address - Country:US
Practice Address - Phone:716-630-1022
Practice Address - Fax:716-250-5958
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2008-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY007077-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000570241002OtherHEALTH NOW
NY00481003Medicaid
NY9512243OtherIHA
NYBB8256Medicaid