Provider Demographics
NPI:1740629393
Name:VAUGHNS, NANCY MAGDY (DO,)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:MAGDY
Last Name:VAUGHNS
Suffix:
Gender:F
Credentials:DO,
Other - Prefix:DR
Other - First Name:NANCY
Other - Middle Name:MAGDY
Other - Last Name:BASTAWROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:312 PROFESSIONAL VIEW DR BLDG 3002ND
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-7904
Mailing Address - Country:US
Mailing Address - Phone:732-431-1616
Mailing Address - Fax:
Practice Address - Street 1:312 PROFESSIONAL VIEW DR BLDG 3002ND
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-7904
Practice Address - Country:US
Practice Address - Phone:732-431-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS-1684207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIVAD000Medicaid
HIVAD000Medicaid