Provider Demographics
NPI:1710795919
Name:DASKALYUK, ENESY STEPANOVNA
Entity type:Individual
Prefix:
First Name:ENESY
Middle Name:STEPANOVNA
Last Name:DASKALYUK
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 1:2258 COUNTY ROAD E W
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-7141
Mailing Address - Country:US
Mailing Address - Phone:612-695-9077
Mailing Address - Fax:
Practice Address - Street 1:2258 COUNTY ROAD E W
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-7141
Practice Address - Country:US
Practice Address - Phone:612-695-9077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy