Provider Demographics
NPI:1053431262
Name:ANDERS, PATRICIA GAIL (NP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:GAIL
Last Name:ANDERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 W 110TH ST
Mailing Address - Street 2:12A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2083
Mailing Address - Country:US
Mailing Address - Phone:212-749-7216
Mailing Address - Fax:
Practice Address - Street 1:519 W 114TH ST
Practice Address - Street 2:3RD FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-7036
Practice Address - Country:US
Practice Address - Phone:212-854-9842
Practice Address - Fax:212-854-9851
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420154-1363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health