=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518057967
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VALERIE DOUNSKI DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 103 RIVER RD SUITE 105
-----------------------------------------------------
City | EDGEWATER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07020-1016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-840-0045
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 WINSTON DR APT #2306
-----------------------------------------------------
City | CLIFFSIDE PARK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07010-3236
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 22DI02193600
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------