Provider Demographics
NPI:1770252918
Name:ANDERSON, DOROTHY FRANCES
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:FRANCES
Last Name:ANDERSON
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 1:904 5TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-4508
Mailing Address - Country:US
Mailing Address - Phone:631-988-5611
Mailing Address - Fax:631-884-8027
Practice Address - Street 1:904 5TH ST
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-4508
Practice Address - Country:US
Practice Address - Phone:631-988-5611
Practice Address - Fax:631-884-8027
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide