Provider Demographics
NPI:1386602829
Name:DYNOF, FRANCIS RONALD (MD)
Entity type:Individual
Prefix:
First Name:FRANCIS
Middle Name:RONALD
Last Name:DYNOF
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 1:963 ROUTE 9 NORTH
Mailing Address - Street 2:
Mailing Address - City:SOUTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08879
Mailing Address - Country:US
Mailing Address - Phone:732-312-5235
Mailing Address - Fax:973-512-4202
Practice Address - Street 1:97 WEST PARKWAY
Practice Address - Street 2:CHILTON MEMORIAL HOSPITAL
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444
Practice Address - Country:US
Practice Address - Phone:973-831-5000
Practice Address - Fax:201-444-3604
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03496300207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1688901Medicaid
NJ089499Medicare ID - Type Unspecified
NJ1688901Medicaid