Provider Demographics
NPI:1699243287
Name:COBBS, DAIJHA CAPRICE (NP)
Entity type:Individual
Prefix:MRS
First Name:DAIJHA
Middle Name:CAPRICE
Last Name:COBBS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:DAIJHA
Other - Middle Name:
Other - Last Name:FULGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:32 CALDERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-1336
Mailing Address - Country:US
Mailing Address - Phone:716-341-9644
Mailing Address - Fax:
Practice Address - Street 1:60 HEDLEY PL
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14208-1061
Practice Address - Country:US
Practice Address - Phone:716-863-4772
Practice Address - Fax:618-822-4099
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF402547363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health