Provider Demographics
NPI:1144774324
Name:DUBAY, BRITTANY (OTR)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:DUBAY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 DEGRANDPRE WAY
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-6451
Mailing Address - Country:US
Mailing Address - Phone:518-561-6361
Mailing Address - Fax:
Practice Address - Street 1:16 DEGRANDPRE WAY
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-6451
Practice Address - Country:US
Practice Address - Phone:518-561-6361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020711174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist