Provider Demographics
NPI:1285115493
Name:DUNKLEY, ADRIENNE DIANE
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:DIANE
Last Name:DUNKLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 BAYCHESTER AVE APT 5A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-4428
Mailing Address - Country:US
Mailing Address - Phone:718-671-3389
Mailing Address - Fax:718-671-3389
Practice Address - Street 1:620 BAYCHESTER AVE APT 5A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4428
Practice Address - Country:US
Practice Address - Phone:718-671-3389
Practice Address - Fax:718-671-3389
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-25
Last Update Date:2018-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY389493-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse