Healthcare Provider Details

I. General information

NPI: 1417234915
Provider Name (Legal Business Name): SHEBA DUBOS- TELFER MS,RN,NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHEBA DUBOS

II. Dates (important events)

Enumeration Date: 11/10/2011
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E 77TH ST
NEW YORK NY
10075-1850
US

IV. Provider business mailing address

1 WOODS AVE
ROCKVILLE CENTRE NY
11570-5933
US

V. Phone/Fax

Practice location:
  • Phone: 212-434-2565
  • Fax:
Mailing address:
  • Phone: 917-710-1298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberF350300
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: