Provider Demographics
NPI:1578740353
Name:DAJDEA, JANE LUCIANA (BS PHARMACY)
Entity Type:Individual
Prefix:MISS
First Name:JANE
Middle Name:LUCIANA
Last Name:DAJDEA
Suffix:
Gender:F
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2977 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1330
Mailing Address - Country:US
Mailing Address - Phone:516-735-8230
Mailing Address - Fax:516-735-8632
Practice Address - Street 1:2977 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1330
Practice Address - Country:US
Practice Address - Phone:516-735-8230
Practice Address - Fax:516-735-8632
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045815183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist