Healthcare Provider Details

I. General information

NPI: 1538255849
Provider Name (Legal Business Name): ANGEL MARIE DWYER REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGEL WHITE

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MUNRO AVE
CAPE MAY NJ
08204-5000
US

IV. Provider business mailing address

53 GIBSON RD
GOSHEN NY
10924-6709
US

V. Phone/Fax

Practice location:
  • Phone: 609-898-6863
  • Fax:
Mailing address:
  • Phone: 845-291-0279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: