Provider Demographics
NPI:1609697648
Name:DOBRINER, NICOLE KATHLEEN
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:KATHLEEN
Last Name:DOBRINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 FRANCO AVE
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-1833
Mailing Address - Country:US
Mailing Address - Phone:631-834-9536
Mailing Address - Fax:
Practice Address - Street 1:45 FRANCO AVE
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-1833
Practice Address - Country:US
Practice Address - Phone:631-834-9536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293741164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse