Provider Demographics
NPI:1962966267
Name:MAGNY, PAULINE A
Entity type:Individual
Prefix:
First Name:PAULINE
Middle Name:A
Last Name:MAGNY
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 1:6201 WOOD POINTE DR
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-2114
Mailing Address - Country:US
Mailing Address - Phone:202-441-0325
Mailing Address - Fax:
Practice Address - Street 1:6201 WOOD POINTE DR
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-2114
Practice Address - Country:US
Practice Address - Phone:202-441-0325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities