Provider Demographics
NPI:1063414308
Name:HALE, PATRICIA L I (MD, PHD, FACP)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:L
Last Name:HALE
Suffix:I
Gender:F
Credentials:MD, PHD, FACP
Other - Prefix:MISS
Other - First Name:PATRICIA
Other - Middle Name:L
Other - Last Name:AUWARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:56 PARKHURST RD
Mailing Address - Street 2:
Mailing Address - City:GANSEVOORT
Mailing Address - State:NY
Mailing Address - Zip Code:12831-1232
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:321 BROADWAY
Practice Address - Street 2:
Practice Address - City:FORT EDWARD
Practice Address - State:NY
Practice Address - Zip Code:12828-1233
Practice Address - Country:US
Practice Address - Phone:518-747-1041
Practice Address - Fax:518-747-1022
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172396-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine