Individual
DIBNAIN NANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
707 E MAIN ST, MIDDLETOWN, NY 10940-2650
(845) 333-7575
(845) 333-7201
Mailing address
707 E MAIN ST, MIDDLETOWN, NY 10940-2650
(845) 333-1114
(845) 333-2645
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
017478
NY
363AS0400X
Surgical Physician Assistant
Primary
017478
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03876208
—
NY
Enumeration date
03/19/2014
Last updated
10/27/2017
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