Provider Demographics
NPI:1083836894
Name:DLADLA, NONKULIE ZWELI (MD)
Entity Type:Individual
Prefix:
First Name:NONKULIE
Middle Name:ZWELI
Last Name:DLADLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5517
Mailing Address - Country:US
Mailing Address - Phone:347-277-8324
Mailing Address - Fax:
Practice Address - Street 1:120 STONEBRIDGE RD
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-1635
Practice Address - Country:US
Practice Address - Phone:347-277-8324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10305700207R00000X
NY237629-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03266502Medicaid
NY55549ES531Medicare PIN