Provider Demographics
NPI:1891455978
Name:PINDER, DAHLIA S
Entity Type:Individual
Prefix:
First Name:DAHLIA
Middle Name:S
Last Name:PINDER
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 1:13919 34TH RD APT B11
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-6424
Mailing Address - Country:US
Mailing Address - Phone:646-922-2324
Mailing Address - Fax:
Practice Address - Street 1:15722 POWELLS COVE BLVD
Practice Address - Street 2:
Practice Address - City:BEECHHURST
Practice Address - State:NY
Practice Address - Zip Code:11357-1332
Practice Address - Country:US
Practice Address - Phone:347-280-3591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1553843211174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist