Provider Demographics
NPI:1568839363
Name:THACKRAY, PATRICIA (MSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:THACKRAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 CENTRAL PARK W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4378
Mailing Address - Country:US
Mailing Address - Phone:212-678-8722
Mailing Address - Fax:
Practice Address - Street 1:444 CENTRAL PARK W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-4378
Practice Address - Country:US
Practice Address - Phone:212-678-8722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator