Provider Demographics
NPI:1609930429
Name:WEBB, DORINDA
Entity Type:Individual
Prefix:MISS
First Name:DORINDA
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 CARNEGIE AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-1215
Mailing Address - Country:US
Mailing Address - Phone:917-478-3914
Mailing Address - Fax:
Practice Address - Street 1:570 ELMONT RD
Practice Address - Street 2:SUITE 301
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-3535
Practice Address - Country:US
Practice Address - Phone:516-437-6050
Practice Address - Fax:516-437-6304
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program