Provider Demographics
NPI:1750440145
Name:BESNER, DEBRA (NP)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:
Last Name:BESNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9525 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4510
Mailing Address - Country:US
Mailing Address - Phone:718-925-6294
Mailing Address - Fax:718-925-6203
Practice Address - Street 1:9525 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4510
Practice Address - Country:US
Practice Address - Phone:718-925-6294
Practice Address - Fax:718-925-6203
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420299363LX0001X
NY420299363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology