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General NPI Number Information
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NPI Number | 1427678341
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Entity Type | Individual
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Provider Name | MARK DEDVUKAJ MD
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Gender | Male
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 435 E 90TH ST
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City | NEW YORK
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State | NY
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Zip | 10128-5103
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Country | US
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Telephone | 732-873-6868
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Fax |
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Provider Business Mailing Address
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Address Line | 30 TYNDALE PL
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City | YONKERS
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State | NY
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Zip | 10701-5431
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Country | US
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Telephone |
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 337788
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License Number State | NY
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