Provider Demographics
NPI:1942588819
Name:NAGY, DAWN (DPT)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:NAGY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 MONMOUTH AVE REAR
Mailing Address - Street 2:
Mailing Address - City:BRADLEY BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:07720-1151
Mailing Address - Country:US
Mailing Address - Phone:732-567-7974
Mailing Address - Fax:
Practice Address - Street 1:1640 ROUTE 88 W
Practice Address - Street 2:SUITE 100
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3068
Practice Address - Country:US
Practice Address - Phone:732-458-7866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01404600225100000X
225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist