Provider Demographics
NPI:1376989046
Name:AHREM, DEBORAH A (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:A
Last Name:AHREM
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:P.O. BOX 354
Mailing Address - Street 2:10 ROCKY HILL RD
Mailing Address - City:MT. SIANI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-1212
Mailing Address - Country:US
Mailing Address - Phone:631-312-3992
Mailing Address - Fax:631-331-8080
Practice Address - Street 1:10 ROCKY HILL RD
Practice Address - Street 2:
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-1212
Practice Address - Country:US
Practice Address - Phone:631-312-3992
Practice Address - Fax:631-331-8080
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306836164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse