Provider Demographics
NPI:1619420056
Name:GEDAROVICH, PATRICIA (DNP, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:GEDAROVICH
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-3312
Mailing Address - Country:US
Mailing Address - Phone:774-277-0208
Mailing Address - Fax:
Practice Address - Street 1:115 MAIN ST STE 2D
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-1469
Practice Address - Country:US
Practice Address - Phone:508-238-7766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN01434363LP0808X
MARN183995363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health