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Individual
PATRICK ANDERSON
Active
Individual
PATRICK ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
010315-1
NY
363A00000X
Physician Assistant
Primary
055.0031225
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02596885
—
NY
01
—
AA1500
MEDICARE GROUP ID
NY
Enumeration date
09/27/2005
Last updated
10/27/2023
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