Provider Demographics
NPI:1700202330
Name:ADZADU, PATRICK (MSW, MED)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:ADZADU
Suffix:
Gender:M
Credentials:MSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N RAMUNNO DR
Mailing Address - Street 2:UNIT # 1203
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-3003
Mailing Address - Country:US
Mailing Address - Phone:302-602-1655
Mailing Address - Fax:
Practice Address - Street 1:410 N RAMUNNO DR UNIT 1203
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-3005
Practice Address - Country:US
Practice Address - Phone:302-602-1655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1041S0200XMedicaid
PA103K00000XMedicaid
PA1041S0200XMedicaid