=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104903400
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. KATHLENE MARGARET NAGY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 635 HIGH MOUNTAIN RD
-----------------------------------------------------
City | NORTH HALEDON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07508-2644
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-427-8100
-----------------------------------------------------
Fax | 973-427-9284
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 635 HIGH MOUNTAIN RD
-----------------------------------------------------
City | NORTH HALEDON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07508-2644
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-427-8100
-----------------------------------------------------
Fax | 973-427-9284
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | DI19202
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------