Healthcare Provider Details

I. General information

NPI: 1578912697
Provider Name (Legal Business Name): DAPHNEY PIERRE- BULY REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2834 ROUTE 17M
NEW HAMPTON NY
10958-5011
US

IV. Provider business mailing address

4 BRIDLE LN
CHESTER NY
10918-1116
US

V. Phone/Fax

Practice location:
  • Phone: 845-374-8700
  • Fax:
Mailing address:
  • Phone: 845-667-7377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number968216
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: