Provider Demographics
NPI:1922211804
Name:URENA, DULCE SOCORRO (MD)
Entity Type:Individual
Prefix:DR
First Name:DULCE
Middle Name:SOCORRO
Last Name:URENA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 NORTHERN BLVD
Mailing Address - Street 2:C.W. POST-LONG ISLAND UNIVERSITY STUDENT HEALTH SERVICE
Mailing Address - City:GREENVALE
Mailing Address - State:NY
Mailing Address - Zip Code:11548-1319
Mailing Address - Country:US
Mailing Address - Phone:516-299-2345
Mailing Address - Fax:516-299-4113
Practice Address - Street 1:720 NORTHERN BLVD
Practice Address - Street 2:C.W. POST-LONG ISLAND UNIVERSITY STUDENT HEALTH SERVICE
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548-1319
Practice Address - Country:US
Practice Address - Phone:516-299-2345
Practice Address - Fax:516-299-4113
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1772752083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF30390Medicare PIN