Provider Demographics
NPI:1477325959
Name:DEHANEY, DAHLIA
Entity Type:Individual
Prefix:
First Name:DAHLIA
Middle Name:
Last Name:DEHANEY
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 1:625 OCEAN AVE APT 5E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-3827
Mailing Address - Country:US
Mailing Address - Phone:718-496-2402
Mailing Address - Fax:
Practice Address - Street 1:625 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-3867
Practice Address - Country:US
Practice Address - Phone:718-496-2402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9502486163W00000X
NY823708-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered Nurse