Healthcare Provider Details

I. General information

NPI: 1538359047
Provider Name (Legal Business Name): ANNE CECILE DADARRIA RN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 07/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 WEST ST
NEWBURGH NY
12550-4217
US

IV. Provider business mailing address

30 ALAN ST
STONE RIDGE NY
12484-5118
US

V. Phone/Fax

Practice location:
  • Phone: 845-562-5778
  • Fax:
Mailing address:
  • Phone: 845-687-0823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF330300-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number320312-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: