Provider Demographics
NPI:1386755650
Name:DUBOIS, MARIA Y (NP)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:Y
Last Name:DUBOIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:75 RED MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-9327
Mailing Address - Country:US
Mailing Address - Phone:914-388-6221
Mailing Address - Fax:845-679-0324
Practice Address - Street 1:15 PINE GROVE ST
Practice Address - Street 2:WOODSTOCK PSYCHIATRIC ADJUNCTIVE SERVICES
Practice Address - City:WOODSTOCK
Practice Address - State:NY
Practice Address - Zip Code:12498-1507
Practice Address - Country:US
Practice Address - Phone:845-679-6678
Practice Address - Fax:845-679-0324
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF332596363L00000X, 363LF0000X
NYF401094-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00473038Medicaid
NY02226424Medicaid
NY00473038Medicaid
NYPO4993Medicare UPIN
NY94N772Medicare ID - Type Unspecified