Provider Demographics
NPI:1669563367
Name:DONDE, DILIP M (MD)
Entity type:Individual
Prefix:DR
First Name:DILIP
Middle Name:M
Last Name:DONDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 IRON BRIDGE RD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728
Mailing Address - Country:US
Mailing Address - Phone:732-294-9373
Mailing Address - Fax:732-333-1366
Practice Address - Street 1:555 IRON BRIDGE RD
Practice Address - Street 2:SUITE 15
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728
Practice Address - Country:US
Practice Address - Phone:732-294-9373
Practice Address - Fax:732-333-1366
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA029723207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
506558OtherAETNA
NY6009290OtherGHI
P912030OtherOXFORD
0024629001OtherAMERIHEALTH
J714OtherHORIZON
NJ6604200Medicaid
992182OtherHEALTHNET
3168563002OtherCIGNA
J714OtherHORIZON
NY6009290OtherGHI