Healthcare Provider Details

I. General information

NPI: 1326457318
Provider Name (Legal Business Name): DOREEN TAYLOR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 SEMINARY HILL RD
CARMEL NY
10512-1921
US

IV. Provider business mailing address

PO BOX 417147
BOSTON MA
02241-7147
US

V. Phone/Fax

Practice location:
  • Phone: 800-989-2676
  • Fax: 845-704-6178
Mailing address:
  • Phone: 518-952-8140
  • Fax: 518-952-8287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number688901
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: