Provider Demographics
NPI:1497768337
Name:EYE, PATRICK S (APRN, BC)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:S
Last Name:EYE
Suffix:
Gender:M
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 S SHORE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MARMORA
Mailing Address - State:NJ
Mailing Address - Zip Code:08223-1200
Mailing Address - Country:US
Mailing Address - Phone:609-390-7814
Mailing Address - Fax:
Practice Address - Street 1:210 S SHORE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:MARMORA
Practice Address - State:NJ
Practice Address - Zip Code:08223-1200
Practice Address - Country:US
Practice Address - Phone:609-390-7814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00098600363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ109078SBVMedicare PIN
NJ109078SUUMedicare PIN
NJ109078QLLMedicare PIN
NJ109078CN9Medicare PIN