Provider Demographics
NPI:1114030996
Name:JINDAL, DILIP KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:DILIP
Middle Name:KUMAR
Last Name:JINDAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2802 PAPERMILL RD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1065
Mailing Address - Country:US
Mailing Address - Phone:610-203-2505
Mailing Address - Fax:484-388-2728
Practice Address - Street 1:2802 PAPERMILL RD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1065
Practice Address - Country:US
Practice Address - Phone:610-203-2505
Practice Address - Fax:484-388-2728
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08100500207R00000X
PAMD433074207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA119581XKLMedicare PIN