Provider Demographics
NPI:1932163433
Name:DWOSH, CATHERINE L (MS, APN-C)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:L
Last Name:DWOSH
Suffix:
Gender:F
Credentials:MS, APN-C
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:L
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, APN-C
Mailing Address - Street 1:120 MADISON AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-2055
Mailing Address - Country:US
Mailing Address - Phone:609-261-1660
Mailing Address - Fax:609-261-1779
Practice Address - Street 1:175 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-2038
Practice Address - Country:US
Practice Address - Phone:609-267-0700
Practice Address - Fax:609-261-4801
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR07875600363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ054255AUAMedicare PIN