Basic Information
| Provider Information | |||||||||
| NPI: | 1528038247 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DORFMAN | ||||||||
| FirstName: | SALLY | ||||||||
| MiddleName: | FAITH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 515 | ||||||||
| Address2: | |||||||||
| City: | CORNWALL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125180515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455342754 | ||||||||
| FaxNumber: | 8455344303 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 WASHINGTON RD | ||||||||
| Address2: | |||||||||
| City: | WEST POINT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109961109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8459383055 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2006 | ||||||||
| LastUpdateDate: | 01/29/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 149730 | NY | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 2083P0500X | 149730 | NY | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Preventive Medicine/Occupational Environmental Medicine |
No ID Information.