Provider Demographics
NPI:1609619964
Name:PATZEK, MATTHEW D (MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:D
Last Name:PATZEK
Suffix:
Gender:M
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 CABIN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:DE
Mailing Address - Zip Code:19943-3143
Mailing Address - Country:US
Mailing Address - Phone:215-603-5027
Mailing Address - Fax:
Practice Address - Street 1:1198 S GOVERNORS AVE STE 201
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-6930
Practice Address - Country:US
Practice Address - Phone:302-382-8698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL8-0010643363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health