MEDICARE: MS. PATRICIA PACE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	PR033542	NY

General Provider Information

NPI Number	:	1215034194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA PACE LCSW

Provider Business Mailing Address
First Line	:	31 CAMBRIDGE RD
Second Line	:
City	:	WHITESBORO
State	:	NY
Zip	:	13492-2231
Country	:	US
Telephone Number	:	315-404-7399
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 CAMBRIDGE RD
Second Line	:
City	:	WHITESBORO
State	:	NY
Zip	:	13492-2231
Country	:	US
Telephone Number	:	315-404-7399
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	10/13/2017

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