Provider Demographics
NPI:1184690869
Name:PATTERSON, JEFFREY M (DC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 WEST BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845
Mailing Address - Country:US
Mailing Address - Phone:607-796-2150
Mailing Address - Fax:607-796-2158
Practice Address - Street 1:301 WEST BROAD STREET
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845
Practice Address - Country:US
Practice Address - Phone:607-796-2150
Practice Address - Fax:607-796-2158
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004118111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T99861Medicare UPIN
NY39850BMedicare ID - Type Unspecified