Provider Demographics
NPI:1851775506
Name:GEISEL, PATRICIA ANNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANNE
Last Name:GEISEL
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 1:84 LYNCREST AVE
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-4655
Mailing Address - Country:US
Mailing Address - Phone:857-719-5055
Mailing Address - Fax:
Practice Address - Street 1:84 LYNCREST AVE
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-4655
Practice Address - Country:US
Practice Address - Phone:857-719-5055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240990163WS0200X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program