Provider Demographics
NPI:1902212574
Name:MCKEITH JAGDEO, DAVLYN
Entity type:Individual
Prefix:
First Name:DAVLYN
Middle Name:
Last Name:MCKEITH JAGDEO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 THWAITES PL APT 5R
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-7908
Mailing Address - Country:US
Mailing Address - Phone:404-579-8251
Mailing Address - Fax:
Practice Address - Street 1:665 THWAITES PL APT 5R
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-7908
Practice Address - Country:US
Practice Address - Phone:404-579-8251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY517196163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse