Mattingly, Patricia A

Mattingly, Patricia A is an individual health care provider with primary practice located at 10 Graham Rd W , Ithaca NY 14850-1055. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Mattingly, Patricia A can be contacted via phone (607) 257-2188.

Contact Information

Primary practice address
10 Graham Rd W Ithaca NY 14850-1055
Phone: (607) 257-2188
Fax: (607) 266-7341
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X F380603 1 New York

Profile Details

NPI number 1760464325
LBN Legal business name Mattingly, Patricia A
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760464325 NPPES
New York MEDICAID 01518285
New York Other 000919177001

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