Provider Demographics
NPI:1861563108
Name:GAYNOR, PATRICIA (NP)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:GAYNOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:DARMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1040 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12307-1508
Mailing Address - Country:US
Mailing Address - Phone:518-374-5353
Mailing Address - Fax:518-347-1413
Practice Address - Street 1:1040 STATE ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12307-1508
Practice Address - Country:US
Practice Address - Phone:518-374-5353
Practice Address - Fax:518-347-1413
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300712363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health