Provider Demographics
NPI:1174662225
Name:BONCROFT, PATRICE B (RN)
Entity type:Individual
Prefix:MS
First Name:PATRICE
Middle Name:B
Last Name:BONCROFT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E 92 ST
Mailing Address - Street 2:APT 4B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212
Mailing Address - Country:US
Mailing Address - Phone:718-493-3213
Mailing Address - Fax:
Practice Address - Street 1:316 BEACH 65TH
Practice Address - Street 2:DAYTOP
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11692
Practice Address - Country:US
Practice Address - Phone:718-474-3800
Practice Address - Fax:718-318-6372
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2582481163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse