Provider Demographics
NPI:1740625698
Name:CURTIS, PATRICIA R
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:R
Last Name:CURTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:R
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:96 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1134
Mailing Address - Country:US
Mailing Address - Phone:516-791-6576
Mailing Address - Fax:
Practice Address - Street 1:96 ROOSEVELT AVE.
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581
Practice Address - Country:US
Practice Address - Phone:516-791-6576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1306140174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5167916576OtherPHONE NUMBER