Healthcare Provider Details

I. General information

NPI: 1922317643
Provider Name (Legal Business Name): GINA M DUGAY RN, CMHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2010
Last Update Date: 09/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1083 MCDONALD AVE
BROOKLYN NY
11230-2651
US

IV. Provider business mailing address

1083 MCDONALD AVE
BROOKLYN NY
11230-2651
US

V. Phone/Fax

Practice location:
  • Phone: 718-421-7444
  • Fax:
Mailing address:
  • Phone: 718-421-7444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number324526
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: