Provider Demographics
NPI:1053331165
Name:DIZOGLIO, JOSPEH D (MD)
Entity Type:Individual
Prefix:
First Name:JOSPEH
Middle Name:D
Last Name:DIZOGLIO
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 1:695 EDDY ST
Mailing Address - Street 2:SUITE 21
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4941
Mailing Address - Country:US
Mailing Address - Phone:401-272-1550
Mailing Address - Fax:401-421-8792
Practice Address - Street 1:695 EDDY ST
Practice Address - Street 2:SUITE 21
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4941
Practice Address - Country:US
Practice Address - Phone:401-272-1550
Practice Address - Fax:401-421-8792
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD03707207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology