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General NPI Number Information
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NPI Number | 1396253290
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Entity Type | Individual
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Provider Name | XIOMARA M. DORREJO AGPCNP
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Gender | Female
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Dates
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Enumeration Date | 01/14/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 19 E 98TH ST STE 4
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City | NEW YORK
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State | NY
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Zip | 10029-6501
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Country | US
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Telephone | 212-241-1101
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Fax |
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Provider Business Mailing Address
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Address Line | ONE GUSTAVE L. LEVY PLACE BOX 1070
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City | NEW YORK
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State | NY
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Zip | 10029
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Country | US
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Telephone |
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 308282-1
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License Number State | NY
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