Healthcare Provider Details

I. General information

NPI: 1871636654
Provider Name (Legal Business Name): AMY M DUNMAN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 SOUTH AVE E
WESTFIELD NJ
07090-1459
US

IV. Provider business mailing address

7 OAK RIDGE RD
BERNARDSVILLE NJ
07924-1807
US

V. Phone/Fax

Practice location:
  • Phone: 908-232-2727
  • Fax:
Mailing address:
  • Phone: 908-204-0343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number25MP00161100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: