Healthcare Provider Details

I. General information

NPI: 1073719035
Provider Name (Legal Business Name): CYNTHIA ELLEN DAUBMAN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 NORTH RD LEXINGTON CENTER FOR RECOVERY METHADONE MAINTENANCE TRE
POUGHKEEPSIE NY
12601-1328
US

IV. Provider business mailing address

21 MANOR DR W
POUGHKEEPSIE NY
12603-3778
US

V. Phone/Fax

Practice location:
  • Phone: 845-486-2850
  • Fax: 845-486-2770
Mailing address:
  • Phone: 845-471-2733
  • Fax: 845-486-2770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number299888-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: