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General NPI Number Information
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NPI Number | 1205992690
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Entity Type | Organization
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Legal Business Name | A.G. DIKENGIL, MD, PA
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 736 PAGE AVE
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City | LYNDHURST
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State | NJ
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Zip | 07071-2541
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Country | US
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Telephone | 201-729-1234
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Fax | 201-729-1233
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Provider Business Mailing Address
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Address Line | 1 HARMON PLZ FL 10
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City | SECAUCUS
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State | NJ
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Zip | 07094-2803
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Country | US
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Telephone | 201-729-1234
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Fax | 201-729-1233
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Authorized Official
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Title or Position | CMO
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Name | GAURANG RAVAJI BRAHMBHATT
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Credential | MD
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Telephone | 201-706-8490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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