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General NPI Number Information
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NPI Number | 1699721043
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Entity Type | Individual
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Provider Name | BRUCE WOODS PATTERSON M.S.W., L.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 01/23/2009
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Provider Practice Location Address
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Address Line | 125 W 16TH ST SUITE 116, LEFT COURTYARD ENTRANCE
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City | NEW YORK
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State | NY
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Zip | 10011-6280
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Country | US
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Telephone | 212-352-3006
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Fax |
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Provider Business Mailing Address
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Address Line | 168 8TH AVE APT. 3-SO.
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City | NEW YORK
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State | NY
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Zip | 10011-1635
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Country | US
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Telephone | 917-589-1928
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Fax | 212-242-5963
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R045120-1
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License Number State | NY
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