Provider Demographics
NPI:1770024069
Name:DASH, JOAN ELIZABETH
Entity Type:Individual
Prefix:MISS
First Name:JOAN
Middle Name:ELIZABETH
Last Name:DASH
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 1:192 COVERT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-1214
Mailing Address - Country:US
Mailing Address - Phone:718-453-6873
Mailing Address - Fax:718-453-6873
Practice Address - Street 1:15 IVES RD
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-2034
Practice Address - Country:US
Practice Address - Phone:516-295-2019
Practice Address - Fax:516-569-0468
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2019-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY947780991174V00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No174V00000XOther Service ProvidersClinical Ethicist