Provider Demographics
NPI:1114264595
Name:DUSHAJ, KOLA (MD)
Entity Type:Individual
Prefix:DR
First Name:KOLA
Middle Name:
Last Name:DUSHAJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 OSCAWANA LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-2601
Mailing Address - Country:US
Mailing Address - Phone:914-557-7909
Mailing Address - Fax:
Practice Address - Street 1:2084 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-2621
Practice Address - Country:US
Practice Address - Phone:914-739-4800
Practice Address - Fax:914-468-2570
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-06
Last Update Date:2020-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275777207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine