Provider Demographics
NPI:1922051689
Name:LYNCH-GADALETA, PATRICIA (PAC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:LYNCH-GADALETA
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:GADALETA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 AMARAL ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-2205
Mailing Address - Country:US
Mailing Address - Phone:401-434-8009
Mailing Address - Fax:
Practice Address - Street 1:50 AMARAL STREET
Practice Address - Street 2:
Practice Address - City:E PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02915
Practice Address - Country:US
Practice Address - Phone:401-434-8009
Practice Address - Fax:401-435-3634
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA000157363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant