Provider Demographics
NPI:1528238110
Name:SCHWEITZER, PATRICIA (RN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SCHWEITZER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 CAMBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-3104
Mailing Address - Country:US
Mailing Address - Phone:631-648-7828
Mailing Address - Fax:
Practice Address - Street 1:1824 VETERANS HWY
Practice Address - Street 2:
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749-1553
Practice Address - Country:US
Practice Address - Phone:631-348-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184614-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01667330Medicaid