Individual
MS. CAMILLE LUCILLE DULLAGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
125 VALLEY ROAD, MONTCLAIR, NJ 07042
(973) 865-5245
Mailing address
105 TIERNEY DRIVE, CEDAR GROVE, NJ 07009
(973) 239-2359
(973) 482-2870
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
784068
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
26NO04249100
NJ
Other
Enumeration date
04/12/2007
Last updated
02/26/2014
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