MRS. DIANNE BARBARA DOUGHERTY


Address: 50 Penbroke Ave, Staten Island, NY 10301-2061
Phone: 7189867674

MRS. DIANNE BARBARA DOUGHERTY (NPI# 1134697808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134697808
Entity Type Individual
Full Name MRS. DIANNE BARBARA DOUGHERTY
Credential FNP
Practice Address 50 Penbroke Ave
Staten Island
NY 10301-2061
Practice Telephone 7189867674
Mailing Telephone 7189867674
Enumeration Date 2018-11-10
Last Update Date 2018-11-10
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
2017026718 NY Physician Assistants & Advanced Practice Nursing Providers

Other Providers DIANNE DOUGHERTY

NPI Name Taxonomy Address Enumeration
1972663771 Dianne Taylor Dougherty Counselor 4096 Barrett Dr, Raleigh, NC 27609-6604 2006-12-11

Office Location

Street Address 50 PENBROKE AVE
City STATEN ISLAND
State NY
Zip Code 10301-2061

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1700262565 Courtney Pryor Speech-Language Pathologist 57 Westbury Avenue, Staten Island, NY 10301 2015-08-04
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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1063039220 Hima Girish Nurse Practitioner 64 Galloway Ave, Staten Island, NY 10302-2528 2020-07-02
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Competitor

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City STATEN ISLAND
Zip Code 10301

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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