Provider Demographics
NPI:1295963965
Name:HAJDINAJ, SHQIPONJA (AUD, DO)
Entity type:Individual
Prefix:
First Name:SHQIPONJA
Middle Name:
Last Name:HAJDINAJ
Suffix:
Gender:F
Credentials:AUD, DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-5103
Mailing Address - Country:US
Mailing Address - Phone:215-707-7237
Mailing Address - Fax:215-707-9389
Practice Address - Street 1:3401 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5103
Practice Address - Country:US
Practice Address - Phone:215-707-7237
Practice Address - Fax:215-707-9389
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006122231H00000X
PAOT017313207R00000X
PAOS0213012085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine