Healthcare Provider Details

I. General information

NPI: 1124831458
Provider Name (Legal Business Name): DEBORAH SUSAN ALGUIRE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 PHILLIPS ST
MASSENA NY
13662-2016
US

IV. Provider business mailing address

472 LACOMB RD
NORFOLK NY
13667-3252
US

V. Phone/Fax

Practice location:
  • Phone: 315-764-8076
  • Fax: 315-764-8079
Mailing address:
  • Phone: 940-808-9264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number705895
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: