Provider Demographics
NPI:1619426624
Name:HAMAL, DIKSHYA (MBBS)
Entity Type:Individual
Prefix:DR
First Name:DIKSHYA
Middle Name:
Last Name:HAMAL
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 GRAND CONCOURSE
Mailing Address - Street 2:BRONX, NY
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7606
Mailing Address - Country:US
Mailing Address - Phone:718-960-1234
Mailing Address - Fax:
Practice Address - Street 1:300 MEDICAL PAVILION DR STE 150
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-0030
Practice Address - Country:US
Practice Address - Phone:910-904-8025
Practice Address - Fax:910-615-9751
Is Sole Proprietor?:No
Enumeration Date:2016-10-03
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2019-02835207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program