Provider Demographics
NPI:1346062478
Name:HOUSE, PATRICIA
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:HOUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18 BEACH RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:NY
Mailing Address - Zip Code:13042-3124
Mailing Address - Country:US
Mailing Address - Phone:315-591-8777
Mailing Address - Fax:
Practice Address - Street 1:1000 E GENESEE ST STE 403
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1840
Practice Address - Country:US
Practice Address - Phone:315-464-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical