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NPI Code Detail

MEDICARE: PAULA KAY DORN NP

MEDICARE: PAULA KAY DORN NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner309489NY

General Provider Information

NPI Number : 1144863689
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULA KAY DORN NP
Provider Business Mailing Address
First Line : 100 KINGS HWY S
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-5504
Country : US
Telephone Number : 315-359-2130
Fax Number : 315-359-2139
Provider Business Practice Location Address
First Line : 1304 DRIVING PARK AVE
Second Line :
City : NEWARK
State : NY
Zip : 14513-1059
Country : US
Telephone Number : 315-359-2130
Fax Number : 315-359-2139
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2019
Last Update Date : 09/16/2022

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