Provider Demographics
NPI:1346347267
Name:SAGONA-DOUGHERTY, MARIA (RN NP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:SAGONA-DOUGHERTY
Suffix:
Gender:F
Credentials:RN NP
Other - Prefix:MISS
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:SAGONA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:24 CARRINGTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731
Mailing Address - Country:US
Mailing Address - Phone:631-266-1057
Mailing Address - Fax:631-266-6040
Practice Address - Street 1:78 MIDDLEVILLE ROAD
Practice Address - Street 2:118
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768
Practice Address - Country:US
Practice Address - Phone:631-261-4400
Practice Address - Fax:631-266-6040
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345942163W00000X
NY340119163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WG0600XNursing Service ProvidersRegistered NurseGerontology