Provider Demographics
NPI:1255467437
Name:DJURDJINOVIC, LUBA (MS)
Entity Type:Individual
Prefix:MS
First Name:LUBA
Middle Name:
Last Name:DJURDJINOVIC
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-3102
Mailing Address - Country:US
Mailing Address - Phone:607-724-4308
Mailing Address - Fax:607-724-8290
Practice Address - Street 1:124 FRONT ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-3102
Practice Address - Country:US
Practice Address - Phone:607-724-4308
Practice Address - Fax:607-724-8290
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS