Individual
JAKOW DIENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
360 BROOK RD, BETHLEHEM, NH 03574-4342
(603) 616-9916
Mailing address
360 BROOK RD, BETHLEHEM, NH 03574-4342
(603) 616-9916
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
12255
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0196371
—
OH
01
—
01Y007264NH01
BLUE CROSS/BLUE SHIELD
NH
05
—
1010617
—
VT
01
—
384132
MVP
NH
01
—
5414126
CIGNA HEALTHCARE
NH
05
—
80300008
—
NH
01
—
AA38042
HARVARD PILGRIM HEALTHCAR
NH
Enumeration date
02/28/2006
Last updated
07/21/2021
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