Provider Demographics
NPI:1942834668
Name:GHUSSIN, PATRICIA ANN (BA, MS, MA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:GHUSSIN
Suffix:
Gender:F
Credentials:BA, MS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 MEDWAY AVE
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-2825
Mailing Address - Country:US
Mailing Address - Phone:347-601-5072
Mailing Address - Fax:
Practice Address - Street 1:88 MEDWAY AVE
Practice Address - Street 2:
Practice Address - City:CONGERS
Practice Address - State:NY
Practice Address - Zip Code:10920-2825
Practice Address - Country:US
Practice Address - Phone:347-601-5072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty