Healthcare Provider Details

I. General information

NPI: 1154265577
Provider Name (Legal Business Name): DEBORA SUE PRESTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 LIBERTY ST
BATH NY
14810-1508
US

IV. Provider business mailing address

5 WARDEN ST
BATH NY
14810-1227
US

V. Phone/Fax

Practice location:
  • Phone: 607-664-2255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number424668-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: