Provider Demographics
NPI:1740212596
Name:GRUNDNER, DOROTHEA L (LPN)
Entity Type:Individual
Prefix:MS
First Name:DOROTHEA
Middle Name:L
Last Name:GRUNDNER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5407 QUAIL RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-4271
Mailing Address - Country:US
Mailing Address - Phone:609-275-5978
Mailing Address - Fax:
Practice Address - Street 1:181 NORTH HARRISON ST.
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540
Practice Address - Country:US
Practice Address - Phone:609-921-2800
Practice Address - Fax:609-921-3499
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP01048300164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse