Provider Demographics
NPI:1164668265
Name:MYERS, DORI A (MS)
Entity Type:Individual
Prefix:MRS
First Name:DORI
Middle Name:A
Last Name:MYERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 RYE HILL RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-4507
Mailing Address - Country:US
Mailing Address - Phone:845-782-0657
Mailing Address - Fax:
Practice Address - Street 1:464 ROUTE 17A
Practice Address - Street 2:
Practice Address - City:FLORIDA
Practice Address - State:NY
Practice Address - Zip Code:10921-1014
Practice Address - Country:US
Practice Address - Phone:845-651-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-20
Last Update Date:2008-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor