Provider Demographics
NPI:1376733469
Name:PICKETT, PATRICIA A (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:PICKETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MENTAL HTH,NORFOLK SHERF
Mailing Address - Street 2:200 WEST STREET
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02027
Mailing Address - Country:US
Mailing Address - Phone:781-751-3363
Mailing Address - Fax:
Practice Address - Street 1:MENTAL HTH,NORFOLK SHERF
Practice Address - Street 2:200 WEST STREET
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02027
Practice Address - Country:US
Practice Address - Phone:781-751-3363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA592532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry