Individual
DR. MARY ELLEN DYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1-3 HENRY W DUBOIS DR, SUITE 1, NEW PALTZ, NY 12561-1420
(845) 255-0977
(845) 255-0933
Mailing address
1-3 HENRY W DUBOIS DR, SUITE 1, NEW PALTZ, NY 12561-1420
(845) 255-0977
(845) 255-0933
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
208649
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01951404
—
NY
01
—
208649
NYS LICENSE
NY
Enumeration date
07/26/2006
Last updated
03/07/2023
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