Healthcare Provider Details

I. General information

NPI: 1356724546
Provider Name (Legal Business Name): AIDA DABREO APN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AIDA E DABREO FNP- BC

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 N SAINT PAUL ST STE 3100
DALLAS TX
75201
US

IV. Provider business mailing address

325 N SAINT PAUL ST STE 3100
DALLAS TX
75201-3923
US

V. Phone/Fax

Practice location:
  • Phone: 917-667-2201
  • Fax:
Mailing address:
  • Phone: 917-667-2201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1071384
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberAC005203
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number1071384
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberAC005203
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number33338306
License Number StateNY
# 6
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number404029
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: