Provider Demographics
NPI:1740358472
Name:DEIBEL, PATRICIA MARY (CNM)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MARY
Last Name:DEIBEL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 MARLBOROUGH ROAD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226
Mailing Address - Country:US
Mailing Address - Phone:585-739-9697
Mailing Address - Fax:
Practice Address - Street 1:225 MARLBOROUGH ROAD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226
Practice Address - Country:US
Practice Address - Phone:718-693-1011
Practice Address - Fax:718-282-7298
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0000441367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife