Provider Demographics
NPI:1396864385
Name:DYCKMAN, STEVEN IRA (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:IRA
Last Name:DYCKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:D4 BRIER HILL CT
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3335
Mailing Address - Country:US
Mailing Address - Phone:732-238-7711
Mailing Address - Fax:732-238-1977
Practice Address - Street 1:D4 BRIER HILL CT
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3335
Practice Address - Country:US
Practice Address - Phone:732-238-7711
Practice Address - Fax:732-238-1977
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA073721002084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry