Provider Demographics
NPI:1003035221
Name:DILLARD, JAMES NEWELL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:NEWELL
Last Name:DILLARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:161 MADISON AVE
Mailing Address - Street 2:SUITE 11E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5421
Mailing Address - Country:US
Mailing Address - Phone:212-265-4038
Mailing Address - Fax:212-750-7405
Practice Address - Street 1:161 MADISON AVE
Practice Address - Street 2:SUITE 11E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5421
Practice Address - Country:US
Practice Address - Phone:212-265-4038
Practice Address - Fax:212-750-7405
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1872242081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02L371Medicare PIN
NYF40493Medicare UPIN