Provider Demographics
NPI:1104903400
Name:NAGY, KATHLENE MARGARET
Entity type:Individual
Prefix:DR
First Name:KATHLENE
Middle Name:MARGARET
Last Name:NAGY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 HIGH MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-2644
Mailing Address - Country:US
Mailing Address - Phone:973-427-8100
Mailing Address - Fax:973-427-9284
Practice Address - Street 1:635 HIGH MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:NORTH HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-2644
Practice Address - Country:US
Practice Address - Phone:973-427-8100
Practice Address - Fax:973-427-9284
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI19202122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist