Provider Demographics
NPI:1720555824
Name:AVERSA, PATSY ANNE (RN)
Entity Type:Individual
Prefix:
First Name:PATSY
Middle Name:ANNE
Last Name:AVERSA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2441
Mailing Address - Country:US
Mailing Address - Phone:315-868-5923
Mailing Address - Fax:
Practice Address - Street 1:561 MAIN STREET
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2441
Practice Address - Country:US
Practice Address - Phone:315-868-5923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-26
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY705766163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty