Basic Information
| Provider Information | |||||||||
| NPI: | 1790981488 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATTETT | ||||||||
| FirstName: | KATHREEN | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 348 BURKHARD AVE | ||||||||
| Address2: | |||||||||
| City: | MINEOLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167410219 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8900 VAN WYCK EXPRESSWAY | ||||||||
| Address2: | |||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114182897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182068784 | ||||||||
| FaxNumber: | 7182066829 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2007 | ||||||||
| LastUpdateDate: | 02/05/2013 | ||||||||
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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 | 176B00000X | 001061 | NY | Y | Other Service Providers | Midwife |
No ID Information.