Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 25MA08047500 | NJ |
NPI | 1215973730 |
---|---|
Provider Name | Joshua Dyme |
First Address | Hackensack, NJ 07601-1758 |
Second Address | Hackensack, NJ 07601-1758 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 10/12/2007 |