DOROTA MIRONIUK


Address: 17 Reagan Way, Kinnelon, NJ 07405-2738
Phone: 2018198900

DOROTA MIRONIUK (NPI# 1477178424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477178424
Entity Type Individual
Full Name DOROTA MIRONIUK
Credential NP-C
Practice Address 17 Reagan Way
Kinnelon
NJ 07405-2738
Practice Telephone 2018198900
Mailing Telephone 2018198900
Mailing Fax Number 9737320436
Enumeration Date 2020-06-15
Last Update Date 2020-06-15
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
AG06200073 NJ Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
17 Reagan Way, Kinnelon, NJ 074052738 2018198900 9737320436

Office Location

Street Address 17 REAGAN WAY
City KINNELON
State NJ
Zip Code 07405-2738

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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

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Competitor

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City KINNELON
Zip Code 07405

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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