Healthcare Provider Details

I. General information

NPI: 1083868459
Provider Name (Legal Business Name): PATRICIA ANN DEAN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TRISH DEAN D.C.

II. Dates (important events)

Enumeration Date: 11/11/2008
Last Update Date: 11/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 W 54TH ST 3RD FL.
NEW YORK NY
10019-5515
US

IV. Provider business mailing address

95 CHRISTOPHER ST APT 1E
NEW YORK NY
10014-6624
US

V. Phone/Fax

Practice location:
  • Phone: 212-262-9178
  • Fax:
Mailing address:
  • Phone: 917-696-2608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX010636
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: