Provider Demographics
NPI:1013698489
Name:PARKINSON, PATICE PAMELA (CRANIAL PROSTHESIS)
Entity Type:Individual
Prefix:MS
First Name:PATICE
Middle Name:PAMELA
Last Name:PARKINSON
Suffix:
Gender:F
Credentials:CRANIAL PROSTHESIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7375 EXECUTIVE PL FL 4
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2278
Mailing Address - Country:US
Mailing Address - Phone:202-873-4308
Mailing Address - Fax:202-916-7996
Practice Address - Street 1:7375 EXECUTIVE PL STE E17
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2278
Practice Address - Country:US
Practice Address - Phone:202-873-4308
Practice Address - Fax:202-916-7996
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier