Provider Demographics
NPI:1720175896
Name:MOLE, DEIRDRE A (RN)
Entity Type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:A
Last Name:MOLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1484 1ST AVE # 1486
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2304
Mailing Address - Country:US
Mailing Address - Phone:212-746-0373
Mailing Address - Fax:212-746-7481
Practice Address - Street 1:1484 1ST AVE # 1486
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2304
Practice Address - Country:US
Practice Address - Phone:212-746-7000
Practice Address - Fax:212-746-0450
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2011-09-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF340468207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine