Provider Demographics
NPI:1609335215
Name:COVINGTON, DYNESYIA SHAKIYRA
Entity Type:Individual
Prefix:
First Name:DYNESYIA
Middle Name:SHAKIYRA
Last Name:COVINGTON
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 1:1374 BOSTON RD APT 2B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-2537
Mailing Address - Country:US
Mailing Address - Phone:646-753-3219
Mailing Address - Fax:
Practice Address - Street 1:1374 BOSTON RD APT 2B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-2537
Practice Address - Country:US
Practice Address - Phone:646-753-3219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker