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General NPI Number Information
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NPI Number | 1114264595
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Entity Type | Individual
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Provider Name | KOLA DUSHAJ MD
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Gender | Male
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Dates
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Enumeration Date | 01/06/2013
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Last Update Date | 12/26/2020
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Provider Practice Location Address
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Address Line | 2084 E MAIN ST
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City | CORTLANDT MANOR
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State | NY
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Zip | 10567-2621
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Country | US
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Telephone | 914-739-4800
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Fax | 914-468-2570
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Provider Business Mailing Address
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Address Line | 226 OSCAWANA LAKE RD
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City | PUTNAM VALLEY
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State | NY
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Zip | 10579-2601
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Country | US
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Telephone | 914-557-7909
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 275777
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License Number State | NY
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