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General NPI Number Information
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NPI Number | 1710244512
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Entity Type | Individual
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Provider Name | DIANA CHOATE PATTERSON MD
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Gender | Female
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Dates
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Enumeration Date | 04/18/2012
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Last Update Date | 04/09/2022
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Provider Practice Location Address
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Address Line | 14 TECHNOLOGY DR STE 11
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City | EAST SETAUKET
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State | NY
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Zip | 11733-3464
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Country | US
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Telephone | 631-216-8187
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Fax | 631-444-8899
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Provider Business Mailing Address
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Address Line | 101 NICHOLS ROAD DEPARTMENT OF ORTHOPAEDICS, HSC T-18, RM 020
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City | STONY BROOK
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State | NY
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Zip | 11794-8181
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Country | US
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Telephone | 631-216-8187
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Fax | 631-444-8899
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 2018008559
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 283069
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License Number State | NY
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