Healthcare Provider Details

I. General information

NPI: 1558287565
Provider Name (Legal Business Name): PAIGE DAUPHINEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9904 BEARTOWN RD N
AVA NY
13303-2102
US

IV. Provider business mailing address

9904 BEARTOWN RD N
AVA NY
13303-2102
US

V. Phone/Fax

Practice location:
  • Phone: 718-222-5999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number4626-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: