Provider Demographics
NPI:1245721133
Name:MINOGUE, PATRICK STEPHEN (PA-C)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:STEPHEN
Last Name:MINOGUE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ROBIN DR
Mailing Address - Street 2:
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1375
Mailing Address - Country:US
Mailing Address - Phone:609-610-9239
Mailing Address - Fax:
Practice Address - Street 1:5 PLAINSBORO ROAD
Practice Address - Street 2:SUITE 450
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-1915
Practice Address - Country:US
Practice Address - Phone:609-853-6390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-25
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00481900363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant