Provider Demographics
NPI:1427375203
Name:PANDYA, DIMPLE M (MD)
Entity Type:Individual
Prefix:DR
First Name:DIMPLE
Middle Name:M
Last Name:PANDYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 NICOLLS RD.
Mailing Address - Street 2:LEVEL 2 RM 749 DEPARTMENT OF PATHOLOGY
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794
Mailing Address - Country:US
Mailing Address - Phone:631-444-2222
Mailing Address - Fax:631-444-3419
Practice Address - Street 1:101 NICOLLS ROAD
Practice Address - Street 2:LEVEL 2, RM 749 DEPARTMENT OF PATHOLOGY
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794
Practice Address - Country:US
Practice Address - Phone:631-444-2222
Practice Address - Fax:631-444-3419
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program