Basic Information
Provider Information
NPI: 1366671679
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PYCHYNSKI
FirstName: DAGMARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 HYGEIA DR
Address2: SUITE 2300
City: NEWARK
State: DE
PostalCode: 197132049
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 774 CHRISTIANA RD
Address2: SUITE 201
City: NEWARK
State: DE
PostalCode: 197134236
CountryCode: US
TelephoneNumber: 3026233017
FaxNumber: 3022669960
Other Information
ProviderEnumerationDate: 07/08/2009
LastUpdateDate: 04/19/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400XD0077657MDY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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