Provider Demographics
NPI:1881915700
Name:UNDERWOOD, PATRICIA LEE (NP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LEE
Last Name:UNDERWOOD
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Gender:F
Credentials:NP
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Mailing Address - Street 1:20 GRAND ST FL 3
Mailing Address - Street 2:CREDENTIALING MANAGER
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1035
Mailing Address - Country:US
Mailing Address - Phone:845-987-3906
Mailing Address - Fax:845-987-5979
Practice Address - Street 1:2 CROSFIELD AVE
Practice Address - Street 2:SUITE 318
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2226
Practice Address - Country:US
Practice Address - Phone:845-353-5600
Practice Address - Fax:845-353-5668
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2015-05-18
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Provider Licenses
StateLicense IDTaxonomies
NY30 305392363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health