Provider Demographics
NPI:1023493632
Name:DEDVUKAJ, DRITA (MS)
Entity type:Individual
Prefix:
First Name:DRITA
Middle Name:
Last Name:DEDVUKAJ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E 26TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1924
Mailing Address - Country:US
Mailing Address - Phone:914-844-4623
Mailing Address - Fax:
Practice Address - Street 1:215 E 26TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-1924
Practice Address - Country:US
Practice Address - Phone:914-844-4623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool