Provider Demographics
NPI:1104178243
Name:DAKA, VERA
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:DAKA
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 1:541 E 71ST ST FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4871
Mailing Address - Country:US
Mailing Address - Phone:917-747-6089
Mailing Address - Fax:
Practice Address - Street 1:17 STUYVESANT OVAL
Practice Address - Street 2:APT 7E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-1920
Practice Address - Country:US
Practice Address - Phone:347-514-1499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-13
Last Update Date:2024-03-01
Deactivation Date:2014-08-26
Deactivation Code:
Reactivation Date:2024-03-01
Provider Licenses
StateLicense IDTaxonomies
NY352076363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty