Provider Demographics
NPI:1205439551
Name:DILBERT, PATRICIA (FNP)
Entity type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:
Last Name:DILBERT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:DILBERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:622 BELVIDERE AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07062-2004
Mailing Address - Country:US
Mailing Address - Phone:917-566-3297
Mailing Address - Fax:
Practice Address - Street 1:622 BELVIDERE AVE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07062-2004
Practice Address - Country:US
Practice Address - Phone:917-566-3297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01054000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily