1184751406 NPI number — MRS. PATRICIA BREWIN DOBRYDNIO EDS,LCADC

Table of content: MRS. PATRICIA BREWIN DOBRYDNIO EDS,LCADC (NPI 1184751406)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184751406 NPI number — MRS. PATRICIA BREWIN DOBRYDNIO EDS,LCADC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOBRYDNIO
Provider First Name:
PATRICIA
Provider Middle Name:
BREWIN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
EDS,LCADC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BREWIN
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
EDS,LCADC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1184751406
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
47 MAPLE ST
Provider Second Line Business Mailing Address:
SUITE L-25
Provider Business Mailing Address City Name:
SUMMIT
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07901-2571
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-273-7866
Provider Business Mailing Address Fax Number:
908-464-5885

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
47 MAPLE ST
Provider Second Line Business Practice Location Address:
SUITE L-25
Provider Business Practice Location Address City Name:
SUMMIT
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07901-2571
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-273-7866
Provider Business Practice Location Address Fax Number:
908-464-5885
Provider Enumeration Date:
02/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  37LC00096700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: 37F100096500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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