Provider Demographics
NPI:1407158355
Name:DAMBRA, JOSEPH N (RN)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:N
Last Name:DAMBRA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PALM RD
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-6730
Mailing Address - Country:US
Mailing Address - Phone:631-813-5182
Mailing Address - Fax:
Practice Address - Street 1:6 PALM RD
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-6730
Practice Address - Country:US
Practice Address - Phone:631-813-5182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307603163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health