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General NPI Number Information
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NPI Number | 1699971937
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Entity Type | Individual
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Provider Name | NIKA DYAKINA D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 1000 LAKE ST # 900C-6
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City | RAMSEY
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State | NJ
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Zip | 07446-1249
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Country | US
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Telephone | 201-250-1579
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Fax | 201-283-9094
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Provider Business Mailing Address
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Address Line | 61 CREST RD
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City | RAMSEY
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State | NJ
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Zip | 07446-1618
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Country | US
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Telephone | 201-250-1579
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Fax | 201-283-9094
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 25MB08570600
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License Number State | NJ
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