Provider Demographics
NPI:1164477667
Name:DIONISIO, CESAR V (MD)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:V
Last Name:DIONISIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:161 RIVERSIDE DR
Mailing Address - Street 2:SUITE M10
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-4112
Mailing Address - Country:US
Mailing Address - Phone:607-770-7222
Mailing Address - Fax:607-770-7221
Practice Address - Street 1:161 RIVERSIDE DR
Practice Address - Street 2:SUITE M10
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4176
Practice Address - Country:US
Practice Address - Phone:607-770-7222
Practice Address - Fax:607-770-7221
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2010-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY151268207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00802084Medicaid
NYB82378Medicare UPIN
NY00802084Medicaid