Provider Demographics
NPI:1114057890
Name:OESTREICHER, DEBORAH SUE (APRN, BC)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:SUE
Last Name:OESTREICHER
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:SUE
Other - Last Name:ROSEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 HIGH POINT RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-3911
Mailing Address - Country:US
Mailing Address - Phone:203-256-9582
Mailing Address - Fax:
Practice Address - Street 1:435 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-1964
Practice Address - Country:US
Practice Address - Phone:230-736-2601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003581364SP0809X
CT073945363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT404601OtherMHN
CT400003581CT01OtherANTHEM
CT400003581CT01OtherANTHEM