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General NPI Number Information
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NPI Number | 1518331651
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Entity Type | Organization
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Legal Business Name | DAWN TREE NURSE PRACTITIONER IN PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 11/29/2015
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Last Update Date | 11/29/2015
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Provider Practice Location Address
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Address Line | 1133 ROUTE 55 C/O ADVANCED CLINICIAN SUPPORT SERVICES, INC
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City | LAGRANGEVILLE
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State | NY
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Zip | 12540-5051
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Country | US
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Telephone | 845-594-8370
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Fax |
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Provider Business Mailing Address
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Address Line | 15 MILEWOOD RD
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City | VERBANK
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State | NY
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Zip | 12585-5023
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Country | US
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Telephone | 845-594-8370
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. DAWN R TREE
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Credential | NPP
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Telephone | 845-594-8370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 401679
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License Number State | NY
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