Provider Demographics
NPI:1972217040
Name:MCGOVERN, PATRICK SEAN
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:SEAN
Last Name:MCGOVERN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1767 PARK AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-1923
Mailing Address - Country:US
Mailing Address - Phone:917-572-3773
Mailing Address - Fax:
Practice Address - Street 1:1767 PARK AVE FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-1923
Practice Address - Country:US
Practice Address - Phone:917-572-3773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker