Provider Demographics
NPI:1144544222
Name:NNAETUK, PATRICIA S (AHNP)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:S
Last Name:NNAETUK
Suffix:
Gender:F
Credentials:AHNP
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Other - Credentials:
Mailing Address - Street 1:1400 PELHAM PARKWAY SOUTH
Mailing Address - Street 2:JACOBI MEDICAL CENTER
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461
Mailing Address - Country:US
Mailing Address - Phone:718-918-6052
Mailing Address - Fax:718-918-7701
Practice Address - Street 1:1400 PELHAM PKWY S BLDG 1
Practice Address - Street 2:JACOBI MEDICAL CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1119
Practice Address - Country:US
Practice Address - Phone:718-918-6052
Practice Address - Fax:718-918-7701
Is Sole Proprietor?:No
Enumeration Date:2010-03-18
Last Update Date:2015-02-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF305133363LA2200X
NY337421364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health