Provider Demographics
NPI:1831624261
Name:LAROSILIERE, PATRICIA (DMD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:LAROSILIERE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 8TH ST APT 8C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3851
Mailing Address - Country:US
Mailing Address - Phone:845-520-0964
Mailing Address - Fax:
Practice Address - Street 1:SUNSET PARK FAMILY HEALTH CENTER AT NYU LANGONE
Practice Address - Street 2:150 55TH STREET
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220
Practice Address - Country:US
Practice Address - Phone:718-630-8419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0600101223P0221X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Yes1223P0221XDental ProvidersDentistPediatric Dentistry