Mana Dejhalla, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

229798 Issued in NY

Practice address

707 E Main St
Middletown, NY 10940-2667

Phone

(845) 333-1000

NPI assigned

Jul 6, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Boston Children'S Health Physicians, LLP

  • Pediatrics Physician
  • Hawthorne, NY
  • NPI 1467454967

  Neonatal-Perinatal Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591056000000",
    "number": "1700817640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WOODS RD",
            "address_2": "DIVISON OF NEWBORN MEDICINE",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402667",
            "telephone_number": "845-333-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "967 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107011301",
            "country_code": "US",
            "telephone_number": "914-964-4444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEJHALLA",
        "first_name": "MANA",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "229798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02782176",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen M Degeorge, BA
• Joyce Deghetto
• Shelly Dehaan, RD
• Julissa Dejesus, LPN
• Patricia Rena Dejesus
• Maria Delourdes Dallin, LMSW
• Ricky Demarse, LCSW
• Kimberly Marie Dembeck, P.A.
• Hui Ling Deng, MD
• Jessica Lynn Dennehy, LMSW

• Neonatal-Perinatal Medicine Physician in Middletown, NY
• Providers in Middletown, NY by specialty
• Neonatal-Perinatal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.