Individual
ANTHONY DEWAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3600 ROUTE 112, CORAM, NY 11727-4116
(631) 920-8672
Mailing address
3600 ROUTE 112, CORAM, NY 11727-4116
(631) 920-8672
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
692184-1
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403642
NY
Other
Enumeration date
07/08/2016
Last updated
12/27/2022
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