Most Relevant Information
Provider Data
| NPI Number: | 1003342650 |
| Provider Name: | DORDONIDE I BACKER |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 324478 |
Most Important Dates
| Enumeration Date: | 05/02/2017 |
| Last Updated: | 05/02/2017 |
Provider Practice Location
43 ROBIN HILL PL
BRENTWOOD
NY
117175709
Practice Location Phone/Fax
| Phone: | 6317424089 |
| Fax: |
Provider Mailing Location
43 ROBIN HILL PL
BRENTWOOD
NY
117175709
Provider Mailing Phone/Fax
| Phone: | 6317424089 |
| Fax: |