Provider Demographics
NPI:1003203209
Name:DOBBS, NYA
Entity Type:Individual
Prefix:
First Name:NYA
Middle Name:
Last Name:DOBBS
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 1:96 GLENSIDE TRL
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1230
Mailing Address - Country:US
Mailing Address - Phone:973-997-9236
Mailing Address - Fax:
Practice Address - Street 1:1101 CAMDEN AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-6837
Practice Address - Country:US
Practice Address - Phone:410-543-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-25
Last Update Date:2015-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer