MEDICARE: MRS. CARA NICOLASA DYER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC05748100	NJ

General Provider Information

NPI Number	:	1194297432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARA NICOLASA DYER

Provider Business Mailing Address
First Line	:	1105 LAWRENCE AVE
Second Line	:
City	:	POINT PLEASANT BORO
State	:	NJ
Zip	:	08742-2341
Country	:	US
Telephone Number	:	732-504-5808
Fax Number	:

Provider Business Practice Location Address
First Line	:	1105 LAWRENCE AVE
Second Line	:
City	:	POINT PLEASANT BORO
State	:	NJ
Zip	:	08742-2341
Country	:	US
Telephone Number	:	732-504-5808
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2018
Last Update Date	:	01/07/2019

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