Provider Demographics
NPI:1417618000
Name:DESUZE, DITZIA E (MSW)
Entity Type:Individual
Prefix:MS
First Name:DITZIA
Middle Name:E
Last Name:DESUZE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 EASTERN PKWY APT 5E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-1470
Mailing Address - Country:US
Mailing Address - Phone:347-788-9026
Mailing Address - Fax:
Practice Address - Street 1:285 LIVINGSTON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1006
Practice Address - Country:US
Practice Address - Phone:718-802-0666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty