Deborah Jo Fell, LPN

Individual provider Active NPI Licensed Practical Nurse · Ontario, NY

NPI 1003980707 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1003980707
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
221673 (NY)
Practice address
7097 Ontario Center Rd
Ontario, NY 14519-9566
Phone
(315) 524-6694
Fax
(315) 524-6694
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
221673NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 221673 NY Yes

Addresses

Primary practice location

7097 Ontario Center Rd
Ontario, NY 14519-9566

Mailing address

7097 Ontario Center Rd
Ontario, NY 14519-9566
Phone (315) 524-6694

Other identifiers

IdentifierTypeStateIssuer
01654535MedicaidNY

Other providers in Ontario, NY

All providers in Ontario, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.