Provider Demographics
NPI:1871550806
Name:DUNKELMAN, NEAL R (MD)
Entity type:Individual
Prefix:MR
First Name:NEAL
Middle Name:R
Last Name:DUNKELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 RYKOWSKI LANE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941
Mailing Address - Country:US
Mailing Address - Phone:845-695-2131
Mailing Address - Fax:845-695-2135
Practice Address - Street 1:42 RYKOWSKI LANE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941
Practice Address - Country:US
Practice Address - Phone:845-695-2131
Practice Address - Fax:845-695-2135
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181211208100000X
NYNY1812112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01735602Medicaid
NY89K631Medicare PIN
NY01735602Medicaid