Provider Demographics
NPI:1841259918
Name:KOOYMAN, PATRICIA SUE (DO)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:SUE
Last Name:KOOYMAN
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:NY INST OF TECHNOLOGY NORTHERN BLVD PO BOX 8000
Mailing Address - Street 2:ACADEMIC HEALTH CARE CENTER NYCOM
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-8000
Mailing Address - Country:US
Mailing Address - Phone:516-686-1300
Mailing Address - Fax:516-686-7890
Practice Address - Street 1:NEW YORK INSTITUTE OF TECHNOLOGY NORTHERN BOULEVARD
Practice Address - Street 2:ACADEMIC HEALTH CARE CENTER NYCOM
Practice Address - City:OLD WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11568-8000
Practice Address - Country:US
Practice Address - Phone:516-686-1300
Practice Address - Fax:516-686-7890
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2008-05-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY234611204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY897791Medicare PIN
I47353Medicare UPIN