Provider Demographics
NPI:1194036541
Name:MCPHOY, PATRICIA (AGNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MCPHOY
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25527 148TH AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-2803
Mailing Address - Country:US
Mailing Address - Phone:718-723-9341
Mailing Address - Fax:
Practice Address - Street 1:1 PENN PLZ
Practice Address - Street 2:STE 725
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10119-0002
Practice Address - Country:US
Practice Address - Phone:718-723-9341
Practice Address - Fax:212-216-6606
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4405991163WS0200X
NY307075363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WS0200XNursing Service ProvidersRegistered NurseSchool