Provider Demographics
NPI:1003383886
Name:EL NAGAR, DOROTA HELENA (LPN)
Entity Type:Individual
Prefix:
First Name:DOROTA
Middle Name:HELENA
Last Name:EL NAGAR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FLORIDA
Mailing Address - State:NY
Mailing Address - Zip Code:10921-1304
Mailing Address - Country:US
Mailing Address - Phone:845-248-0114
Mailing Address - Fax:
Practice Address - Street 1:30 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:FLORIDA
Practice Address - State:NY
Practice Address - Zip Code:10921-1304
Practice Address - Country:US
Practice Address - Phone:845-248-0114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190205164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse