Provider Demographics
NPI:1700513355
Name:CALVIN, DOREEN ANN MARIE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:ANN MARIE
Last Name:CALVIN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:DOREEN
Other - Middle Name:ANNMARIE
Other - Last Name:CALVIN-DUNKLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DUNKLEY
Mailing Address - Street 1:14220 232ND ST
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-3630
Mailing Address - Country:US
Mailing Address - Phone:347-619-4277
Mailing Address - Fax:
Practice Address - Street 1:14220 232ND ST
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-3630
Practice Address - Country:US
Practice Address - Phone:347-619-4277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY823668-02163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse