Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 25MB09840300 | NJ |
Y | 207Q00000X | Family Doctor | 25MB09840300 | NJ |
NPI | 1487996062 |
---|---|
Provider Name | Dorothy Marie Klingmeyer |
First Address | Boston, MA 02241-6457 |
Second Address | Morristown, NJ 07960-6422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2013 |
Last Update Date | 08/05/2019 |