MEDICARE: MARYANN DEWAR

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
1	164W00000X	Licensed Practical Nurse	056925-1	NY

General Provider Information

NPI Number	:	1154569101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYANN DEWAR

Provider Business Mailing Address
First Line	:	2853 CHERRY CT
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-1902
Country	:	US
Telephone Number	:	516-766-4432
Fax Number	:

Provider Business Practice Location Address
First Line	:	2853 CHERRY CT
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-1902
Country	:	US
Telephone Number	:	516-766-4432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2009
Last Update Date	:	03/22/2026

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Directions to “ MARYANN DEWAR ” Practice Location

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