Individual
MS. PATRICIA D. PAVLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
123 CONHOCTON ST, CORNING, NY 14830-2911
(607) 962-5402
(607) 962-1502
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
(607) 962-5102
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F333802
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02679270
—
NY
01
—
CC8362
RR MEDICARE GROUP
NY
01
—
P00387773
RR MEDICARE PIN
NY
Enumeration date
02/15/2006
Last updated
09/15/2011
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