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Individual
DR. KELLI LEIGH PATENAUDE
Active
Individual
DR. KELLI LEIGH PATENAUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
011154
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10110754
CDPHP
NY
01
—
1065576
ASHN
NY
01
—
204061411
LANDMARK
NY
01
—
20406141101
PRISM HEALTH NETWORK
NY
01
—
C11154-4W
WORKERS' COMPENSATION
NY
01
—
NY11154
MVP HEALTH PLAN
NY
01
—
X08P31
BLUE CROSS / BLUE SHIELD
NY
Enumeration date
07/26/2006
Last updated
07/08/2007
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