Provider Demographics
NPI:1982335824
Name:MUNGCAL, DINAH LISING (APN)
Entity Type:Individual
Prefix:
First Name:DINAH
Middle Name:LISING
Last Name:MUNGCAL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 FOX HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-4939
Mailing Address - Country:US
Mailing Address - Phone:908-265-6851
Mailing Address - Fax:
Practice Address - Street 1:43 FOX HOLLOW DR
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-4939
Practice Address - Country:US
Practice Address - Phone:908-265-6851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPENDING363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty