Provider Demographics
NPI:1245775410
Name:VYKREST, DILFUZA
Entity Type:Individual
Prefix:
First Name:DILFUZA
Middle Name:
Last Name:VYKREST
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 1:2018 VOORHIES AVE
Mailing Address - Street 2:B8
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2942
Mailing Address - Country:US
Mailing Address - Phone:718-801-0530
Mailing Address - Fax:
Practice Address - Street 1:2018 VOORHIES AVE
Practice Address - Street 2:B8
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2942
Practice Address - Country:US
Practice Address - Phone:718-801-0530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-27
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY707716163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse