Provider Demographics
NPI:1770314577
Name:DIKA, BESIM
Entity type:Individual
Prefix:
First Name:BESIM
Middle Name:
Last Name:DIKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SISCAR PL
Mailing Address - Street 2:
Mailing Address - City:BEACON
Mailing Address - State:NY
Mailing Address - Zip Code:12508-1022
Mailing Address - Country:US
Mailing Address - Phone:845-549-3480
Mailing Address - Fax:
Practice Address - Street 1:10 SISCAR PL
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-1022
Practice Address - Country:US
Practice Address - Phone:845-549-3480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)