Provider Demographics
NPI:1669695953
Name:DUNST, ELIZABETH DIAS (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:DIAS
Last Name:DUNST
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 OAKLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-1648
Mailing Address - Country:US
Mailing Address - Phone:516-801-6430
Mailing Address - Fax:
Practice Address - Street 1:128A GLEN ST
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2737
Practice Address - Country:US
Practice Address - Phone:516-802-5562
Practice Address - Fax:516-802-5563
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334717363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily