Provider Demographics
NPI:1700214624
Name:GUCLU, PATRICIA (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:GUCLU
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PENN PLZ FRNT 7
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10119-0206
Mailing Address - Country:US
Mailing Address - Phone:201-410-5361
Mailing Address - Fax:201-410-5361
Practice Address - Street 1:1 PENN PLZ FRNT 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10119-0206
Practice Address - Country:US
Practice Address - Phone:201-410-5361
Practice Address - Fax:201-410-5361
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-31
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF306595363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health