Provider Demographics
NPI:1891085908
Name:PATENAUDE, CHARLENE L (MD,)
Entity Type:Individual
Prefix:DR
First Name:CHARLENE
Middle Name:L
Last Name:PATENAUDE
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 1:150 INFIRMARY WAY
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01003-9288
Mailing Address - Country:US
Mailing Address - Phone:413-545-2337
Mailing Address - Fax:413-577-5117
Practice Address - Street 1:111 THATCHER RD OFC 1127
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01003-9362
Practice Address - Country:US
Practice Address - Phone:413-545-2337
Practice Address - Fax:413-545-9602
Is Sole Proprietor?:No
Enumeration Date:2011-04-10
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2620632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry