Provider Demographics
NPI:1457036659
Name:DUGBATEY, SHADRACK KWAKU (MD)
Entity Type:Individual
Prefix:
First Name:SHADRACK
Middle Name:KWAKU
Last Name:DUGBATEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 THE RISE
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-2114
Mailing Address - Country:US
Mailing Address - Phone:917-340-9465
Mailing Address - Fax:
Practice Address - Street 1:BRONX - LEBANON HOSPITAL CENTER, 1650 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457
Practice Address - Country:US
Practice Address - Phone:917-340-9465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program