Basic Information
Provider Information
NPI: 1235355090
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AMES
FirstName: PATRICIA
MiddleName: MAUREEN
NamePrefix: MS.
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 110 S. BEDFORD ROAD
Address2: MOUNT KISCO MEDICAL GROUP PC
City: MOUNT KISCO
State: NY
PostalCode: 10549
CountryCode: US
TelephoneNumber: 9142411050
FaxNumber: 9142421516
Practice Location
Address1: 110 S. BEDFORD ROAD.
Address2: MOUNT KISCO
City: MOUNT KISCO
State: NY
PostalCode: 10549
CountryCode: US
TelephoneNumber: 9142411050
FaxNumber: 9142421516
Other Information
ProviderEnumerationDate: 04/18/2007
LastUpdateDate: 04/03/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XF330901NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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