=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720279219
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DOREEN GAIL BISCHOF FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2007
-----------------------------------------------------
Last Update Date | 02/02/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 29 N HAMILTON ST
-----------------------------------------------------
City | POUGHKEEPSIE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12601-2541
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-486-2963
-----------------------------------------------------
Fax | 845-486-3531
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 52 MAIN ST
-----------------------------------------------------
City | POUGHQUAG
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12570-5628
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-264-0078
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | F342330
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 423320-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------