Provider Demographics
NPI:1215512413
Name:GLADYS L. DUMA, LCSW P.C.
Entity type:Organization
Organization Name:GLADYS L. DUMA, LCSW P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:LUCIA
Authorized Official - Last Name:DUMA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:646-427-8464
Mailing Address - Street 1:9018 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-1335
Mailing Address - Country:US
Mailing Address - Phone:646-427-8464
Mailing Address - Fax:
Practice Address - Street 1:45 35 67TH STREET UNIT MD1
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377
Practice Address - Country:US
Practice Address - Phone:646-427-8464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health