Provider Demographics
NPI:1689893828
Name:ADLER, DOROTHY (NP)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:ADLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S. BEDFORD RD
Mailing Address - Street 2:CREDENTIALING DEPT
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3441
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:1985 CROMPOND RD
Practice Address - Street 2:CARE MOUNT MEDICAL PC
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4146
Practice Address - Country:US
Practice Address - Phone:914-241-1050
Practice Address - Fax:914-739-0973
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY420210363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03507004Medicaid
NYA400077640Medicare PIN