Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MA55098 | NJ |
N | 111NI0900X | Internist | MA55098 | NJ |
N | 207RC0200X | Critical Care Medicine | MA55098 | NJ |
Y | 207RP1001X | Pulmonary Disease | MA55098 | NJ |
NPI | 1073687273 |
---|---|
Provider Name | Yahya Mete Dikengil |
First Address | Cedar Grove, NJ 07009-1814 |
Second Address | Cedar Grove, NJ 07009-1814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 04/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01/01/1961 | CORRECT BIRTHDATE (01) | |
0173918 | GHI (01) | NJ |
1542052 | AETNA HMO (01) | NJ |
223586872 | TAX ID# (01) | NJ |
3K6310 | HEALTHNET (01) | NJ |
7155466 | AETNA PPO (01) | NJ |
H79192 | (02) | |
P3805276 | OXFORD (01) | NJ |