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General NPI Number Information
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NPI Number | 1346265626
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Entity Type | Individual
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Provider Name | JOAN MARIE DORAN NP
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Gender | Female
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 700 E BRIGHTON AVE
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City | SYRACUSE
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State | NY
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Zip | 13205-2201
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Country | US
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Telephone | 315-413-3375
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Fax | 315-492-1672
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Provider Business Mailing Address
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Address Line | 700 E BRIGHTON AVE
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City | SYRACUSE
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State | NY
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Zip | 13205-2201
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Country | US
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Telephone | 315-413-3375
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Fax | 315-492-1672
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 178268-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F300893
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | F340410
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License Number State | NY
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