Healthcare Provider Details

I. General information

NPI: 1023579612
Provider Name (Legal Business Name): DILJOT SINGH DHILLON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 VALLEY HEALTH PLZ
PARAMUS NJ
07652-3619
US

IV. Provider business mailing address

61 DRESSAGE PL
FREEHOLD NJ
07728-9372
US

V. Phone/Fax

Practice location:
  • Phone: 925-518-8293
  • Fax:
Mailing address:
  • Phone: 925-518-8293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number25MB12534900
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: