Provider Demographics
NPI:1255411732
Name:DORSEY, DORIS A (RNP)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:A
Last Name:DORSEY
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 KRUEGER CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-3464
Mailing Address - Country:US
Mailing Address - Phone:718-579-2500
Mailing Address - Fax:718-579-2599
Practice Address - Street 1:MMG - CHCC
Practice Address - Street 2:305 EAST 161ST STREET
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451
Practice Address - Country:US
Practice Address - Phone:718-579-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420117363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner