Provider Demographics
NPI:1346260767
Name:ROONEY, PATRICK S (PA)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:S
Last Name:ROONEY
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:230 CLEARFIELD AVE.
Mailing Address - Street 2:SUITE #124
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1832
Mailing Address - Country:US
Mailing Address - Phone:757-321-3383
Mailing Address - Fax:757-321-3332
Practice Address - Street 1:733 VOLVO PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1609
Practice Address - Country:US
Practice Address - Phone:757-321-3383
Practice Address - Fax:757-321-3332
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2015-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110-002346363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0110-002346OtherSTATE LICENSE
VA1072600OtherNCCPA