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NPI Code Detail

MEDICARE: BERNADETTE DUBE

MEDICARE: BERNADETTE DUBE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerF338626-1NY

General Provider Information

NPI Number : 1891114773
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERNADETTE DUBE
Provider Business Mailing Address
First Line : 325 MAIN ST
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-1790
Country : US
Telephone Number : 631-261-4445
Fax Number :
Provider Business Practice Location Address
First Line : 325 MAIN ST
Second Line :
City : NORTHPORT
State : NY
Zip : 11768-1790
Country : US
Telephone Number : 631-261-4445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2014
Last Update Date : 04/08/2014

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Directions to “ BERNADETTE DUBE ” Practice Location

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