Healthcare Provider Details

I. General information

NPI: 1437083409
Provider Name (Legal Business Name): DORINE FLEURY CHARLIEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 S FRANKLIN AVE
VALLEY STREAM NY
11580-6102
US

IV. Provider business mailing address

79 S FRANKLIN AVE
VALLEY STREAM NY
11580-6102
US

V. Phone/Fax

Practice location:
  • Phone: 516-444-6954
  • Fax:
Mailing address:
  • Phone: 516-444-6954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN27992
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: