Individual
DAWN M DIECIDUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2500 NESCONSET HIGHWAY, BUILDING 23, STONY BROOK, NY 11790
(631) 246-9100
(631) 246-9156
Mailing address
7 EVERIT PLACE, SMITHTOWN, NY 11787
(631) 724-5126
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F420410
NY
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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