Provider Demographics
NPI:1073687273
Name:DIKENGIL, YAHYA METE (MD)
Entity Type:Individual
Prefix:
First Name:YAHYA
Middle Name:METE
Last Name:DIKENGIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 POMPTON AVE
Mailing Address - Street 2:STE 8
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1814
Mailing Address - Country:US
Mailing Address - Phone:973-433-0665
Mailing Address - Fax:973-433-0668
Practice Address - Street 1:388 POMPTON AVE
Practice Address - Street 2:STE 8
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1814
Practice Address - Country:US
Practice Address - Phone:973-433-0665
Practice Address - Fax:973-433-0668
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA55098207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0173918OtherGHI
NJ1542052OtherAETNA HMO
NJ223586872OtherTAX ID#
NJP3805276OtherOXFORD
NJ7155466OtherAETNA PPO
01/01/1961OtherCORRECT BIRTHDATE
NJ3K6310OtherHEALTHNET
NJ067572MFWMedicare PIN
NJ3K6310OtherHEALTHNET