Healthcare Provider Details

I. General information

NPI: 1710951090
Provider Name (Legal Business Name): PATRICIA MCGRATH C R N P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 10/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 C HUNTINGDON PIKE
ROCKLEDGE PA
19046-4431
US

IV. Provider business mailing address

2500 MARYLAND RD STE 400
WILLOW GROVE PA
19090-1225
US

V. Phone/Fax

Practice location:
  • Phone: 215-780-2000
  • Fax: 215-780-2007
Mailing address:
  • Phone: 215-481-4143
  • Fax: 215-481-6790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberVP05443B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: