Provider Demographics
NPI:1851614077
Name:DABO, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DABO
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 1:695 SAINT NICHOLAS AVE APT 54
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-1050
Mailing Address - Country:US
Mailing Address - Phone:646-407-7584
Mailing Address - Fax:718-978-0032
Practice Address - Street 1:16937 144TH RD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-5929
Practice Address - Country:US
Practice Address - Phone:718-978-7226
Practice Address - Fax:718-978-0032
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY623670163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse