Provider Demographics
NPI:1215658299
Name:DORWAY, LYNETTE P (NP)
Entity type:Individual
Prefix:MISS
First Name:LYNETTE
Middle Name:P
Last Name:DORWAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 BALDWIN DR
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-1442
Mailing Address - Country:US
Mailing Address - Phone:646-639-4755
Mailing Address - Fax:
Practice Address - Street 1:827 BALDWIN DR
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-1442
Practice Address - Country:US
Practice Address - Phone:516-343-0037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF310854-01363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health