Provider Demographics
NPI:1457819575
Name:HASANGJEKAJ, INDIRA DJELOVIC (FNP)
Entity Type:Individual
Prefix:MRS
First Name:INDIRA
Middle Name:DJELOVIC
Last Name:HASANGJEKAJ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 WHIPSTICK RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-5009
Mailing Address - Country:US
Mailing Address - Phone:917-833-2552
Mailing Address - Fax:
Practice Address - Street 1:95 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6148
Practice Address - Country:US
Practice Address - Phone:203-739-7029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10172363L00000X
NYF342674363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner