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Organization
THEODORE DIKTABAN, MD PLLC
Active
Organization
THEODORE DIKTABAN, MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA LEONE (OFFICE MANAGAER)
(212) 988-5656
Entity
Organization
Contact information
Practice address
1016 5TH AVE, NEW YORK, NY 10028-0132
(212) 988-5656
Mailing address
1016 5TH AVE, NEW YORK, NY 10028-0132
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
131434
NY
Other
Enumeration date
05/27/2011
Last updated
05/27/2011
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