Provider Demographics
NPI:1497270532
Name:ADJETEY, DIONNE SUSAN
Entity Type:Individual
Prefix:
First Name:DIONNE
Middle Name:SUSAN
Last Name:ADJETEY
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 1:2212 STRANG AVE BSMT
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-2312
Mailing Address - Country:US
Mailing Address - Phone:646-673-1747
Mailing Address - Fax:
Practice Address - Street 1:2212 STRANG AVE.
Practice Address - Street 2:#BASEMENT
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466
Practice Address - Country:US
Practice Address - Phone:646-673-1747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY581535163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse