Provider Demographics
NPI:1699971937
Name:DYAKINA, NIKA (DO)
Entity type:Individual
Prefix:DR
First Name:NIKA
Middle Name:
Last Name:DYAKINA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 CREST RD
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1618
Mailing Address - Country:US
Mailing Address - Phone:201-250-1579
Mailing Address - Fax:201-283-9094
Practice Address - Street 1:1000 LAKE ST # 900C-6
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1249
Practice Address - Country:US
Practice Address - Phone:201-250-1579
Practice Address - Fax:201-283-9094
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB085706002084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ03088951Medicaid