Basic Information
| Provider Information | |||||||||
| NPI: | 1083371132 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRANCIS | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1978 CROMPOND RD | ||||||||
| Address2: | |||||||||
| City: | CORTLANDT MANOR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105674111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147392185 | ||||||||
| FaxNumber: | 9147392121 | ||||||||
| Practice Location | |||||||||
| Address1: | 1978 CROMPOND RD | ||||||||
| Address2: | |||||||||
| City: | CORTLANDT MANOR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105674111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147392121 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2021 | ||||||||
| LastUpdateDate: | 01/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 5390 | CT | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AM0700X | 5390 | CT | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363AS0400X | 027807 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.