Healthcare Provider Details

I. General information

NPI: 1174287247
Provider Name (Legal Business Name): ADRIAN L DOZIER NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2021
Last Update Date: 10/26/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1368 WEBSTER AVE
BRONX NY
10456-1810
US

IV. Provider business mailing address

1368 WEBSTER AVE APT 3G
BRONX NY
10456-1849
US

V. Phone/Fax

Practice location:
  • Phone: 646-226-3996
  • Fax:
Mailing address:
  • Phone: 646-226-3996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF339981-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: