Provider Demographics
NPI:1073087664
Name:DRUMMOND, DIJANA
Entity Type:Individual
Prefix:
First Name:DIJANA
Middle Name:
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14846 HUXLEY ST
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-2720
Mailing Address - Country:US
Mailing Address - Phone:917-332-8527
Mailing Address - Fax:
Practice Address - Street 1:75 S BROADWAY
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4413
Practice Address - Country:US
Practice Address - Phone:914-293-5001
Practice Address - Fax:877-579-8823
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY654936163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine