Provider Demographics
NPI:1902907850
Name:DAJDEA, MIHAELA (PA)
Entity Type:Individual
Prefix:MS
First Name:MIHAELA
Middle Name:
Last Name:DAJDEA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MIHAELA
Other - Middle Name:
Other - Last Name:VOICU DAJEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:959 BRUSH HOLLOW RD
Mailing Address - Street 2:MUSCULOSCHELETAL PAIN MANAGEMENT
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590
Mailing Address - Country:US
Mailing Address - Phone:516-334-8877
Mailing Address - Fax:
Practice Address - Street 1:176-60 UNION TURNPIKE, SUITE 360
Practice Address - Street 2:QUEENS MEDICAL ASSOCIATES
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1531
Practice Address - Country:US
Practice Address - Phone:718-460-2300
Practice Address - Fax:347-225-9930
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010633363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00246075Medicaid
NY00330128Medicare UPIN