Provider Demographics
NPI:1841201936
Name:DREYFUSS, PATRICIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:A
Last Name:DREYFUSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 US HIGHWAY 46
Mailing Address - Street 2:BUILDING D, SUITE 27
Mailing Address - City:MOUNTAIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07046-1668
Mailing Address - Country:US
Mailing Address - Phone:973-334-3345
Mailing Address - Fax:973-263-3142
Practice Address - Street 1:115 US HIGHWAY 46
Practice Address - Street 2:BUILDING D, SUITE 27
Practice Address - City:MOUNTAIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07046-1668
Practice Address - Country:US
Practice Address - Phone:973-334-3345
Practice Address - Fax:973-263-3142
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA039576174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC53752Medicare ID - Type Unspecified