Individual
PATRICIA A MATTINGLY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
10 GRAHAM RD W, ITHACA, NY 14850-1055
(607) 257-2188
(607) 266-7341
Mailing address
10 GRAHAM RD W, ITHACA, NY 14850-1055
(607) 257-2188
(607) 266-7341
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F380603 1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000919177001
HEALTH NOW
—
05
—
01518285
—
NY
Enumeration date
11/18/2005
Last updated
07/08/2007
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