Individual
THETA S PATTISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2508 WESTERN AVE, ALTAMONT, NY 12009-9485
(518) 690-0177
(518) 690-0169
Mailing address
2508 WESTERN AVE, ALTAMONT, NY 12009-9485
(518) 690-0177
(518) 690-0169
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
188200
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01429336
—
NY
Enumeration date
07/07/2005
Last updated
01/29/2016
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