Provider Demographics
NPI:1790981488
Name:PATTETT, KATHREEN JAMES (CNM)
Entity Type:Individual
Prefix:MRS
First Name:KATHREEN
Middle Name:JAMES
Last Name:PATTETT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 BURKHARD AVE
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501
Mailing Address - Country:US
Mailing Address - Phone:516-741-0219
Mailing Address - Fax:
Practice Address - Street 1:8900 VAN WYCK EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11418-2897
Practice Address - Country:US
Practice Address - Phone:718-206-8784
Practice Address - Fax:718-206-6829
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001061176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife