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NPI Code Detail

MEDICARE: DR. STEVEN IRA DYCKMAN MD

MEDICARE:  DR. STEVEN IRA DYCKMAN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry PhysicianMA07372100NJ

General Provider Information

NPI Number : 1396864385
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN IRA DYCKMAN MD
Provider Business Mailing Address
First Line : D4 BRIER HILL CT
Second Line :
City : EAST BRUNSWICK
State : NJ
Zip : 08816-3335
Country : US
Telephone Number : 732-238-7711
Fax Number : 732-238-1977
Provider Business Practice Location Address
First Line : D4 BRIER HILL CT
Second Line :
City : EAST BRUNSWICK
State : NJ
Zip : 08816-3335
Country : US
Telephone Number : 732-238-7711
Fax Number : 732-238-1977
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 07/08/2007

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Directions to “ DR. STEVEN IRA DYCKMAN MD” Practice Location

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