Provider Demographics
NPI:1639616360
Name:DIGNITY CARE MEDICAL CONCIERGE, PA
Entity Type:Organization
Organization Name:DIGNITY CARE MEDICAL CONCIERGE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:CAROLYN
Authorized Official - Last Name:CLAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:732-609-3671
Mailing Address - Street 1:12 BADMINTON CT
Mailing Address - Street 2:
Mailing Address - City:SEA BRIGHT
Mailing Address - State:NJ
Mailing Address - Zip Code:07760-2147
Mailing Address - Country:US
Mailing Address - Phone:732-609-3671
Mailing Address - Fax:
Practice Address - Street 1:12 BADMINTON CT
Practice Address - Street 2:
Practice Address - City:SEA BRIGHT
Practice Address - State:NJ
Practice Address - Zip Code:07760-2147
Practice Address - Country:US
Practice Address - Phone:732-609-3671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00692100251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care