Provider Demographics
NPI:1093796211
Name:DOWLING, KATHLEEN A (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:DOWLING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 STATE ROUTE 33
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-6104
Mailing Address - Country:US
Mailing Address - Phone:732-897-3990
Mailing Address - Fax:732-897-3997
Practice Address - Street 1:2240 STATE ROUTE 33
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-6104
Practice Address - Country:US
Practice Address - Phone:732-897-3990
Practice Address - Fax:732-897-3997
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ07346900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJBD8155714OtherDEA
NJI16953Medicare UPIN
NJ083636Medicare ID - Type Unspecified