Healthcare Provider Details

I. General information

NPI: 1306764006
Provider Name (Legal Business Name): DOROTA HAJDUK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 5TH AVENUE 11TH FLOOR, SUITE 4
NEW YORK NY
10001
US

IV. Provider business mailing address

6120 GRAND CENTRAL PKWY APT B1209
FOREST HILLS NY
11375-1243
US

V. Phone/Fax

Practice location:
  • Phone: 201-500-4903
  • Fax: 833-907-2300
Mailing address:
  • Phone: 646-248-0699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF408582-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: