Provider Demographics
NPI:1700120367
Name:SIMPSON, PATRICK AKEEM (LPN)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:AKEEM
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 BENSON AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2311
Mailing Address - Country:US
Mailing Address - Phone:347-278-0010
Mailing Address - Fax:
Practice Address - Street 1:279 BENSON AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-2311
Practice Address - Country:US
Practice Address - Phone:347-278-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3126721164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY471453835OtherUSA PASSPORT
NY471453835OtherUSA PASSPORT