Healthcare Provider Details

I. General information

NPI: 1205367620
Provider Name (Legal Business Name): WILLIAM PATTEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3959 BROADWAY
NEW YORK NY
10032-1559
US

IV. Provider business mailing address

3959 BROADWAY
NEW YORK NY
10032-1559
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-5437
  • Fax:
Mailing address:
  • Phone: 212-305-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number296549
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: