Provider Demographics
NPI:1720416092
Name:MADHI, DHURATA (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:DHURATA
Middle Name:
Last Name:MADHI
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1788 79TH ST
Mailing Address - Street 2:2ND FL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-1614
Mailing Address - Country:US
Mailing Address - Phone:718-415-5680
Mailing Address - Fax:
Practice Address - Street 1:675 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5704
Practice Address - Country:US
Practice Address - Phone:212-922-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY668056163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse