Provider Demographics
NPI:1649577560
Name:DEWANJEE, JESSIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSIE
Middle Name:
Last Name:DEWANJEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 TUCKAHOE RD
Mailing Address - Street 2:APT-2D
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-5259
Mailing Address - Country:US
Mailing Address - Phone:757-234-6651
Mailing Address - Fax:
Practice Address - Street 1:720 TUCKAHOE RD
Practice Address - Street 2:APT-2D
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-5259
Practice Address - Country:US
Practice Address - Phone:757-243-6651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-13
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11111208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist