Dmytrienko, Igor

Dmytrienko, Igor is an individual health care provider with primary practice located at 51 Chestnut St , Ridgewood NJ 07450-3873. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Dmytrienko, Igor can be contacted via phone (201) 670-9215.

Contact Information

Primary practice address
51 Chestnut St Ridgewood NJ 07450-3873
Phone: (201) 670-9215
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 25MA06920100 New Jersey

Profile Details

NPI number 1881730026
LBN Legal business name Dmytrienko, Igor
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 29th, 2007
Last updated Sep 20th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881730026 NPPES
New Jersey MEDICAID 8056803

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