Provider Demographics
NPI:1336454297
Name:DOROBEK, THERESE KATHRYN
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:KATHRYN
Last Name:DOROBEK
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 1:147 E 90TH ST
Mailing Address - Street 2:#2C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-2357
Mailing Address - Country:US
Mailing Address - Phone:914-885-4978
Mailing Address - Fax:
Practice Address - Street 1:147 E 90TH ST
Practice Address - Street 2:#2C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-2357
Practice Address - Country:US
Practice Address - Phone:914-885-4978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY612525-1163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator