Provider Demographics
NPI:1104929264
Name:DIOKNO, RAUL L (MD)
Entity type:Individual
Prefix:
First Name:RAUL
Middle Name:L
Last Name:DIOKNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:29 CLOVER FIELD DR
Mailing Address - Street 2:
Mailing Address - City:LOUDONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12211-1929
Mailing Address - Country:US
Mailing Address - Phone:518-489-3495
Mailing Address - Fax:
Practice Address - Street 1:STRATTON VA MEDICAL CENTER 113 HOLLAND AVE.
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208
Practice Address - Country:US
Practice Address - Phone:518-626-6350
Practice Address - Fax:518-626-6353
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1285272085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology