Provider Demographics
NPI:1356724546
Name:DABREO, AIDA (APN-BC)
Entity type:Individual
Prefix:
First Name:AIDA
Middle Name:
Last Name:DABREO
Suffix:
Gender:F
Credentials:APN-BC
Other - Prefix:MS
Other - First Name:AIDA
Other - Middle Name:E
Other - Last Name:DABREO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP- BC
Mailing Address - Street 1:325 N SAINT PAUL ST STE 3100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-3923
Mailing Address - Country:US
Mailing Address - Phone:917-667-2201
Mailing Address - Fax:
Practice Address - Street 1:325 N SAINT PAUL ST STE 3100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201
Practice Address - Country:US
Practice Address - Phone:917-667-2201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10713842084P0800X, 2084P0802X
MDAC0052032084P0800X, 2084P0802X
NY33338306363LF0000X
NY4040292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily