Basic Information
| Provider Information | |||||||||
| NPI: | 1194036541 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCPHOY | ||||||||
| FirstName: | PATRICIA | ||||||||
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| Credential: | AGNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25527 148TH AVE | ||||||||
| Address2: | |||||||||
| City: | ROSEDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114222803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187239341 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 PENN PLZ | ||||||||
| Address2: | STE 725 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 101190002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187239341 | ||||||||
| FaxNumber: | 2122166606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2010 | ||||||||
| LastUpdateDate: | 06/18/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WS0200X | 4405991 | NY | N | Nursing Service Providers | Registered Nurse | School | 363LA2200X | 307075 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.