Provider Demographics
NPI:1538359047
Name:DADARRIA, ANNE CECILE (RN FNP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:CECILE
Last Name:DADARRIA
Suffix:
Gender:F
Credentials:RN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 ALAN ST
Mailing Address - Street 2:
Mailing Address - City:STONE RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12484-5118
Mailing Address - Country:US
Mailing Address - Phone:845-687-0823
Mailing Address - Fax:
Practice Address - Street 1:26 WEST ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-4217
Practice Address - Country:US
Practice Address - Phone:845-562-5778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320312-1163W00000X
NYF330300-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse