Provider Demographics
NPI:1184613986
Name:BESSETTE, DEBORAH EMMA (NP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:EMMA
Last Name:BESSETTE
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 1:142 AARON CT
Mailing Address - Street 2:WILLOW PARK COMPLEX
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-2962
Mailing Address - Country:US
Mailing Address - Phone:845-339-6755
Mailing Address - Fax:845-339-1014
Practice Address - Street 1:142 AARON CT
Practice Address - Street 2:WILLOW PARK COMPLEX
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-2962
Practice Address - Country:US
Practice Address - Phone:845-339-6755
Practice Address - Fax:845-339-1014
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302165-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01948223Medicaid
NY97V231Medicare ID - Type Unspecified
NYS64667Medicare UPIN