Healthcare Provider Details

I. General information

NPI: 1861543662
Provider Name (Legal Business Name): DAVID JOEL BIKOFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 08/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 ROUTE 17 NORTH 3RD FLOOR
HACKENSACK NJ
07601
US

IV. Provider business mailing address

146 ROUTE 17 NORTH 3RD FLOOR
HACKENSACK NJ
07601
US

V. Phone/Fax

Practice location:
  • Phone: 201-488-8584
  • Fax: 201-488-7572
Mailing address:
  • Phone: 201-488-8584
  • Fax: 201-488-7572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMA36206
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: