Provider Demographics
NPI:1326519737
Name:DORRIAN, SEAN
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:DORRIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:RED HOOK
Mailing Address - State:NY
Mailing Address - Zip Code:12571-1021
Mailing Address - Country:US
Mailing Address - Phone:845-616-8471
Mailing Address - Fax:
Practice Address - Street 1:18 AMHERST ST
Practice Address - Street 2:
Practice Address - City:RED HOOK
Practice Address - State:NY
Practice Address - Zip Code:12571-1021
Practice Address - Country:US
Practice Address - Phone:845-616-8471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer