Individual
KRISTINA MARIE DAUERNHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
19 DAVIS AVE, 4TH FLOOR HOPE TOWER, NEPTUNE, NJ 07753
(732) 974-0003
Mailing address
19 DAVIS AVE, 4TH FLOOR HOPE TOWER, NEPTUNE, NJ 07753
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
25MP00582200
NJ
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
25MP00582200
NJ
Other
Enumeration date
06/20/2020
Last updated
10/09/2020
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