Provider Demographics
NPI:1548565914
Name:MCADAM, PATRICIA DUDEK (RN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:DUDEK
Last Name:MCADAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PINE HILL CT
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-3441
Mailing Address - Country:US
Mailing Address - Phone:631-754-9398
Mailing Address - Fax:
Practice Address - Street 1:4 PINE HILL CT
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-3441
Practice Address - Country:US
Practice Address - Phone:631-754-9398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY318465-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse