Provider Demographics
NPI:1164628822
Name:PATTERSON, ARTHUR (DC)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 GREENLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2256
Mailing Address - Country:US
Mailing Address - Phone:718-447-7447
Mailing Address - Fax:
Practice Address - Street 1:136 GREENLEAF AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-2256
Practice Address - Country:US
Practice Address - Phone:718-447-7447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3544111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX19531Medicare ID - Type Unspecified