Healthcare Provider Details

I. General information

NPI: 1013942200
Provider Name (Legal Business Name): DEBORAH A OKONIEWSKI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 NORTH STATE RD
BRIARCLIFF MANOR NY
10510
US

IV. Provider business mailing address

465 NORTH STATE RD
BRIARCLIFF MANOR NY
10510
US

V. Phone/Fax

Practice location:
  • Phone: 914-762-5810
  • Fax: 914-762-4223
Mailing address:
  • Phone: 914-762-5810
  • Fax: 914-762-4223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF3323891
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: