Provider Demographics
NPI:1952422669
Name:JUARBE, DOREEN (NP)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:
Last Name:JUARBE
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 1:1 GULL DR
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-1102
Mailing Address - Country:US
Mailing Address - Phone:718-470-7288
Mailing Address - Fax:718-347-0392
Practice Address - Street 1:27005 76TH AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1433
Practice Address - Country:US
Practice Address - Phone:718-470-7288
Practice Address - Fax:718-347-0392
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335123363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner