Provider Demographics
NPI:1093329179
Name:HERRERA VASQUEZ, DHARMA DILIA (MD)
Entity Type:Individual
Prefix:
First Name:DHARMA DILIA
Middle Name:
Last Name:HERRERA VASQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DHARMA
Other - Middle Name:
Other - Last Name:HERRERA VASQUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6711 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3570
Mailing Address - Country:US
Mailing Address - Phone:347-653-5215
Mailing Address - Fax:
Practice Address - Street 1:7901 BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-2156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program