Healthcare Provider Details

I. General information

NPI: 1568604049
Provider Name (Legal Business Name): DAWN MARIE CIDONI R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2009
Last Update Date: 03/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 SUNSET DR
SHIRLEY NY
11967-1756
US

IV. Provider business mailing address

6 SUNSET DR
SHIRLEY NY
11967-1756
US

V. Phone/Fax

Practice location:
  • Phone: 631-399-5512
  • Fax:
Mailing address:
  • Phone: 631-399-5512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number607660-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: