Provider Demographics
NPI:1770918708
Name:LOVELL, DHEYDRA FRANCOISE (MSED)
Entity type:Individual
Prefix:MS
First Name:DHEYDRA
Middle Name:FRANCOISE
Last Name:LOVELL
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1657 NOSTRAND AVE
Mailing Address - Street 2:APT 3R
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-5579
Mailing Address - Country:US
Mailing Address - Phone:917-302-0467
Mailing Address - Fax:
Practice Address - Street 1:1657 NOSTRAND AVE
Practice Address - Street 2:APT 3R
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-5579
Practice Address - Country:US
Practice Address - Phone:917-302-0467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1387659174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist