Healthcare Provider Details

I. General information

NPI: 1730095886
Provider Name (Legal Business Name): PATRICIA KADLUBOWSKI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 WESTCHESTER AVE STE 402
WHITE PLAINS NY
10604-3535
US

IV. Provider business mailing address

6210 99TH ST APT 2L
REGO PARK NY
11374-1442
US

V. Phone/Fax

Practice location:
  • Phone: 914-898-9575
  • Fax:
Mailing address:
  • Phone: 646-704-2318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number360651
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: