Basic Information
| Provider Information | |||||||||
| NPI: | 1144471657 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEJOYA | ||||||||
| FirstName: | HIRUT | ||||||||
| MiddleName: | |||||||||
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| Credential: | PHAMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9-11 W 110TH ST | ||||||||
| Address2: | APT 35 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100264343 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123488259 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 423 E 23RD ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100105011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126867500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2008 | ||||||||
| LastUpdateDate: | 10/02/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PS42008 | FL | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.