Provider Demographics
NPI:1083995906
Name:DINZEY, DIANA GISSELL
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:GISSELL
Last Name:DINZEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:762 BRADY AVE
Mailing Address - Street 2:APT. 529
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-2760
Mailing Address - Country:US
Mailing Address - Phone:646-202-0176
Mailing Address - Fax:
Practice Address - Street 1:762 BRADY AVE
Practice Address - Street 2:APT. 529
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-2760
Practice Address - Country:US
Practice Address - Phone:646-202-0176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2015-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner