Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MA08411800 | NJ |
Y | 2080P0208X | Pediatric Infectious Diseases | MA08411800 | NJ |
NPI | 1578565040 |
---|---|
Provider Name | Dr. Maria Agnes C Dawis |
First Address | Neptune, NJ 07753-4401 |
Second Address | Neptune, NJ 07753-4401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 26/01/2017 |