Provider Demographics
NPI:1124717590
Name:DORCEUS, KATHIA (RN)
Entity type:Individual
Prefix:
First Name:KATHIA
Middle Name:
Last Name:DORCEUS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MARTIN PL APT 2R
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-3971
Mailing Address - Country:US
Mailing Address - Phone:908-943-5998
Mailing Address - Fax:
Practice Address - Street 1:12 MARTIN PL APT 2R
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-3971
Practice Address - Country:US
Practice Address - Phone:908-943-5998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY879593163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse