Provider Demographics
NPI:1407388382
Name:PATIL NG-A-KIEN, SAMEEKSHA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SAMEEKSHA
Middle Name:
Last Name:PATIL NG-A-KIEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:SAMEEKSHA
Other - Middle Name:
Other - Last Name:PATIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:190 CONGRESS PARK DR
Mailing Address - Street 2:STE # 160
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4706
Mailing Address - Country:US
Mailing Address - Phone:561-330-4358
Mailing Address - Fax:
Practice Address - Street 1:190 CONGRESS PARK DR
Practice Address - Street 2:STE # 160
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4706
Practice Address - Country:US
Practice Address - Phone:561-330-4358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9110175363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant