Provider Demographics
NPI:1811073182
Name:BRIJLALL, DEVIKA (RNP)
Entity type:Individual
Prefix:
First Name:DEVIKA
Middle Name:
Last Name:BRIJLALL
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 NEWBOLD AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4711
Mailing Address - Country:US
Mailing Address - Phone:718-741-2450
Mailing Address - Fax:718-944-5362
Practice Address - Street 1:MMC - DEPT. OF PEDIATRICS
Practice Address - Street 2:3415 BAINBRIDGE AVENUE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-741-2450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF381436363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner