Provider Demographics
NPI:1811106404
Name:DUFFY, PATRICIA F
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:F
Last Name:DUFFY
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:F
Other - Last Name:DUFFY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA
Mailing Address - Street 1:6 LANGLEY CT
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11776-3416
Mailing Address - Country:US
Mailing Address - Phone:631-642-7551
Mailing Address - Fax:
Practice Address - Street 1:6 LANGLEY CT
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-3416
Practice Address - Country:US
Practice Address - Phone:631-642-7551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0027391174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist