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NPI Code Detail

MEDICARE: PATRICIA ANDERSON MD

MEDICARE: PATRICIA ANDERSON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician204242NY

General Provider Information

NPI Number : 1710983044
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA ANDERSON MD
Provider Business Mailing Address
First Line : 1065 SOUTHERN BLVD
Second Line :
City : BRONX
State : NY
Zip : 10459-2417
Country : US
Telephone Number : 718-589-2440
Fax Number :
Provider Business Practice Location Address
First Line : 1065 SOUTHERN BLVD
Second Line :
City : BRONX
State : NY
Zip : 10459-2417
Country : US
Telephone Number : 718-589-2440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 06/21/2011

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Directions to “ PATRICIA ANDERSON MD” Practice Location

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