Healthcare Provider Details

I. General information

NPI: 1770576589
Provider Name (Legal Business Name): DAVID DINHOFER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2142 STATE ROUTE 26
VESTAL NY
13850-5810
US

IV. Provider business mailing address

2142 STATE ROUTE 26
VESTAL NY
13850-5810
US

V. Phone/Fax

Practice location:
  • Phone: 607-348-4925
  • Fax: 607-239-5854
Mailing address:
  • Phone: 607-348-4925
  • Fax: 607-239-5854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA09734000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number144721
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: