Provider Demographics
NPI:1972750479
Name:POWELL, PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:POWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TIA
Other - Middle Name:
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:100 W 89TH ST
Mailing Address - Street 2:PH-2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1932
Mailing Address - Country:US
Mailing Address - Phone:212-595-2775
Mailing Address - Fax:
Practice Address - Street 1:100 W 89TH ST
Practice Address - Street 2:PH-2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1932
Practice Address - Country:US
Practice Address - Phone:212-595-2775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1751712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry