Provider Demographics
NPI:1053432427
Name:MCCLOY, DOROTHY ELIZABETH (LPN)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:ELIZABETH
Last Name:MCCLOY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 TEAL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CAPE MAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08204-2836
Mailing Address - Country:US
Mailing Address - Phone:609-886-5943
Mailing Address - Fax:
Practice Address - Street 1:301 TEAL AVE
Practice Address - Street 2:
Practice Address - City:NORTH CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-2836
Practice Address - Country:US
Practice Address - Phone:609-886-5943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP05508500164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse