Healthcare Provider Details

I. General information

NPI: 1134934573
Provider Name (Legal Business Name): ANN-MARIE DAWSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 02/12/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 YORK STREET
UTICA NY
13502-1320
US

IV. Provider business mailing address

15 BIRCH RD
SYRACUSE NY
13209-1206
US

V. Phone/Fax

Practice location:
  • Phone: 315-738-3800
  • Fax:
Mailing address:
  • Phone: 315-480-9517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number663036
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: