Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00184100 | NJ |
NPI | 1023252764 |
---|---|
Provider Name | Mrs. Dana Felicia Pratola |
First Address | Toms River, NJ 08755-1482 |
Second Address | Manahawkin, NJ 08050-2483 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2009 |
Last Update Date | 03/11/2014 |