Provider Demographics
NPI:1245467588
Name:LEVY, PATRICE LEE (APN)
Entity type:Individual
Prefix:MS
First Name:PATRICE
Middle Name:LEE
Last Name:LEVY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MS
Other - First Name:PATRICE
Other - Middle Name:LEE
Other - Last Name:REIMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:123 HARRISON RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-4531
Mailing Address - Country:US
Mailing Address - Phone:974-633-7944
Mailing Address - Fax:
Practice Address - Street 1:123 HARRISON RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-4531
Practice Address - Country:US
Practice Address - Phone:974-633-7944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-14
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ0095100363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner