Provider Demographics
NPI:1316256605
Name:DORSETT, NIKITA MARIE
Entity type:Individual
Prefix:
First Name:NIKITA
Middle Name:MARIE
Last Name:DORSETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2835 WEBB AVE
Mailing Address - Street 2:7F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-2122
Mailing Address - Country:US
Mailing Address - Phone:917-757-7590
Mailing Address - Fax:
Practice Address - Street 1:750 ASTOR AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-9304
Practice Address - Country:US
Practice Address - Phone:718-882-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program