Healthcare Provider Details

I. General information

NPI: 1346574639
Provider Name (Legal Business Name): PATRICE CARLOTTA RYCE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2009
Last Update Date: 09/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W 57TH ST 11TH FLOOR
NEW YORK NY
10019-3320
US

IV. Provider business mailing address

340 E 53RD ST APT 4C
NEW YORK NY
10022-5228
US

V. Phone/Fax

Practice location:
  • Phone: 212-632-4733
  • Fax: 212-632-4534
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: