Individual
KATHLEEN A DAGATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
101 2ND ST, LAKEWOOD, NJ 08701-3324
(732) 363-6655
(732) 363-6656
Mailing address
101 2ND ST, LAKEWOOD, NJ 08701-3324
(732) 636-6655
(732) 901-0277
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NO05477300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015547
—
NJ
01
—
2K7628
HEALTHNET
NJ
Enumeration date
09/20/2006
Last updated
12/02/2011
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