Individual
LUCIAN V DAJDEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6685 FOREST AVENUE, FOREST MEDICAL PC, RIDGEWOOD, NY 11385
(718) 456-9733
(718) 418-2547
Mailing address
6685 FOREST AVENUE, FOREST MEDICAL PC, RIDGEWOOD, NY 11385
(718) 456-9733
(718) 418-2547
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
153356
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0056085
GHI
—
05
—
00811945
—
NY
01
—
12D481
BCBS
—
01
—
153356
HIP
—
01
—
4117285
AETNA
—
01
—
4C3684
HEALTHNET
—
01
—
6604339004
CIGNA
—
01
—
DP008
OXF
—
Enumeration date
03/21/2006
Last updated
07/08/2007
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