Healthcare Provider Details

I. General information

NPI: 1033100136
Provider Name (Legal Business Name): MAUREEN B. DOYLE APRN, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 HARVARD CT
WHITE PLAINS NY
10605-1604
US

IV. Provider business mailing address

12 HARVARD CT
WHITE PLAINS NY
10605-1604
US

V. Phone/Fax

Practice location:
  • Phone: 914-949-1087
  • Fax:
Mailing address:
  • Phone: 914-949-1087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number187007-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: