Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0208X | Pediatric Infectious Diseases | 25MA06319200 | NJ |
Y | 2080P0208X | Pediatric Infectious Diseases | C10012379 | DE |
NPI | 1003980467 |
---|---|
Provider Name | Barry Dashefsky |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 06/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5214904 | (05) | NJ |
B41785 | (02) |