Basic Information
Provider Information
NPI: 1316929391
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DREYER
FirstName: ANNE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 68 S SERVICE RD
Address2: SUITE 350
City: MELVILLE
State: NY
PostalCode: 117472354
CountryCode: US
TelephoneNumber: 5169453000
FaxNumber:  
Practice Location
Address1: 888 OLD COUNTRY RD
Address2:  
City: PLAINVIEW
State: NY
PostalCode: 118034914
CountryCode: US
TelephoneNumber: 5167193000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/16/2005
LastUpdateDate: 11/06/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X375124NYY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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