Provider Demographics
NPI:1154639730
Name:PATTERSON, KAYANNA EMELY (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KAYANNA
Middle Name:EMELY
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KAYANNA
Other - Middle Name:EMELY
Other - Last Name:MORRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7901 BROADWAY DEPT OF
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1329
Mailing Address - Country:US
Mailing Address - Phone:718-334-3392
Mailing Address - Fax:718-334-5886
Practice Address - Street 1:1650 GRAND CONCOURSE
Practice Address - Street 2:BRONX LEBANON HOSPITAL CENTER-ENT DEPARTMENT
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7606
Practice Address - Country:US
Practice Address - Phone:718-901-6901
Practice Address - Fax:718-518-5280
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013997363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant