Provider Demographics
NPI:1750546727
Name:GUERCIO, PATRICIA ANNE (NP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANNE
Last Name:GUERCIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HSC T16 ROOM 080
Mailing Address - Street 2:NICHOLLS ROAD
Mailing Address - City:STONYBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794
Mailing Address - Country:US
Mailing Address - Phone:631-444-1066
Mailing Address - Fax:631-444-1054
Practice Address - Street 1:HSC T16 ROOM 080
Practice Address - Street 2:NICHOLLS ROAD
Practice Address - City:STONYBROOK
Practice Address - State:NY
Practice Address - Zip Code:11794
Practice Address - Country:US
Practice Address - Phone:631-444-1066
Practice Address - Fax:631-444-1054
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF302435363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health