Provider Demographics
NPI:1518376169
Name:LANCASTER, PATRICK F (PMHNP)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:F
Last Name:LANCASTER
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763-4022
Mailing Address - Country:US
Mailing Address - Phone:631-566-7829
Mailing Address - Fax:
Practice Address - Street 1:164 CHERRY LN
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-4022
Practice Address - Country:US
Practice Address - Phone:631-566-7829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-07
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF405650-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health