Provider Demographics
NPI:1487137022
Name:PATTIS, LAUREN NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:NICOLE
Last Name:PATTIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:NICOLE
Other - Last Name:CAROSI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:33 E 33RD ST FL 12
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5362
Mailing Address - Country:US
Mailing Address - Phone:844-337-6362
Mailing Address - Fax:646-665-3604
Practice Address - Street 1:315 E NORTHFIELD RD STE 2A
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4800
Practice Address - Country:US
Practice Address - Phone:800-843-2384
Practice Address - Fax:646-665-3604
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant