Provider Demographics
NPI:1700674025
Name:SKENDERIJA, MIRNA
Entity type:Individual
Prefix:
First Name:MIRNA
Middle Name:
Last Name:SKENDERIJA
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 1:285 PUTNAM AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-1977
Mailing Address - Country:US
Mailing Address - Phone:607-232-3238
Mailing Address - Fax:
Practice Address - Street 1:143 WIMAN AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308-3342
Practice Address - Country:US
Practice Address - Phone:718-356-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist