Individual
JONATHAN CHARLES DYCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
127 S BROADWAY, YONKERS, NY 10701-4006
(845) 392-2338
Mailing address
127 S BROADWAY, YONKERS, NY 10701-4006
(914) 378-7546
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
682002
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402902
NY
Other
Enumeration date
01/03/2020
Last updated
05/13/2020
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