Provider Demographics
NPI:1063182129
Name:DJOKIC, SYLWIA DOROTA (LMT)
Entity type:Individual
Prefix:
First Name:SYLWIA
Middle Name:DOROTA
Last Name:DJOKIC
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 24TH ST
Mailing Address - Street 2:
Mailing Address - City:COPIAGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11726-2902
Mailing Address - Country:US
Mailing Address - Phone:631-708-4248
Mailing Address - Fax:
Practice Address - Street 1:78 24TH ST
Practice Address - Street 2:
Practice Address - City:COPIAGUE
Practice Address - State:NY
Practice Address - Zip Code:11726-2902
Practice Address - Country:US
Practice Address - Phone:631-708-4248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031913-01225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist