Provider Demographics
NPI:1659991008
Name:PATTERSON, AYESHA (LPN,IBCLC)
Entity Type:Individual
Prefix:
First Name:AYESHA
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LPN,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5045 FOXDALE DR
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-2234
Mailing Address - Country:US
Mailing Address - Phone:646-275-4982
Mailing Address - Fax:
Practice Address - Street 1:5045 FOXDALE DR
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-2234
Practice Address - Country:US
Practice Address - Phone:646-275-4982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-24
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty