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General NPI Number Information
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NPI Number | 1679897185
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Entity Type | Individual
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Provider Name | ROBERT JOSHUA DYM MD
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Gender | Male
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Dates
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Enumeration Date | 03/26/2010
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 111 E 210TH ST
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City | BRONX
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State | NY
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Zip | 10467-2401
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Country | US
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Telephone | 718-920-4321
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Fax |
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Provider Business Mailing Address
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Address Line | 622 CHURCHILL RD
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City | TEANECK
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State | NJ
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Zip | 07666-2956
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Country | US
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Telephone | 347-218-1256
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 255874-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 255874-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | 255874-1
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 255874-1
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MA0942030
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License Number State | NJ
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