Individual
JAMES E. PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-5430
Mailing address
32507 HAWKS LAKE LN, SORRENTO, FL 32776-7738
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
25MP00691400
NJ
363AS0400X
Surgical Physician Assistant
PA9101332
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291312700
—
FL
Enumeration date
10/13/2005
Last updated
06/07/2022
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