Provider Demographics
NPI:1700033446
Name:BRAVER, PATRICIA ANGELL (MSED)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANGELL
Last Name:BRAVER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HOLLY DR
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-5221
Mailing Address - Country:US
Mailing Address - Phone:631-543-2757
Mailing Address - Fax:631-543-2757
Practice Address - Street 1:3 HOLLY DR
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-5221
Practice Address - Country:US
Practice Address - Phone:631-543-2757
Practice Address - Fax:631-543-2757
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health