Provider Demographics
NPI:1679914824
Name:LAJARA, YESSENIA
Entity Type:Individual
Prefix:MRS
First Name:YESSENIA
Middle Name:
Last Name:LAJARA
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 1:2 FORDHAM HILL OVAL
Mailing Address - Street 2:APT 6C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-4704
Mailing Address - Country:US
Mailing Address - Phone:718-629-8521
Mailing Address - Fax:
Practice Address - Street 1:5030 BROADWAY
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-1609
Practice Address - Country:US
Practice Address - Phone:212-795-9888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program