Provider Demographics
NPI:1649228248
Name:IRBY, DAHLIA J (MD)
Entity Type:Individual
Prefix:DR
First Name:DAHLIA
Middle Name:J
Last Name:IRBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DAHLIA
Other - Middle Name:J
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:151 FRIES MILL RD STE 102
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2056
Mailing Address - Country:US
Mailing Address - Phone:856-352-6660
Mailing Address - Fax:856-269-4258
Practice Address - Street 1:188 FRIES MILL RD
Practice Address - Street 2:SUITE N-3
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2015
Practice Address - Country:US
Practice Address - Phone:856-875-3565
Practice Address - Fax:856-875-3591
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070230L2084N0400X
NJMA741022084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ057741Medicare ID - Type Unspecified
PA039469NWEMedicare ID - Type Unspecified
NJH20621Medicare UPIN