Healthcare Provider Details

I. General information

NPI: 1114743838
Provider Name (Legal Business Name): DIALOG HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2024
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 SURRATTS RD
CLINTON MD
20735-3353
US

IV. Provider business mailing address

50 CHESTNUT RIDGE RD STE 130
MONTVALE NJ
07645-1841
US

V. Phone/Fax

Practice location:
  • Phone: 212-734-6621
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ESTHER L KRUG
Title or Position: OWNER
Credential:
Phone: 410-933-6423