Provider Demographics
NPI:1386894491
Name:CIAMPA, PATRICIA (RN, BSN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:CIAMPA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:EDRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:352 W 110TH ST
Mailing Address - Street 2:SUITE 14B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2637
Mailing Address - Country:US
Mailing Address - Phone:212-767-9239
Mailing Address - Fax:212-280-1629
Practice Address - Street 1:352 W 110TH ST
Practice Address - Street 2:SUITE 14B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-2637
Practice Address - Country:US
Practice Address - Phone:212-767-9239
Practice Address - Fax:212-280-1629
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY522420163W00000X
NJ26NR13558800163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse