Provider Demographics
NPI:1184009516
Name:PORTNOY, DILNOZA (NP)
Entity Type:Individual
Prefix:
First Name:DILNOZA
Middle Name:
Last Name:PORTNOY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E 53RD ST
Mailing Address - Street 2:APT C1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5243
Mailing Address - Country:US
Mailing Address - Phone:212-610-0488
Mailing Address - Fax:212-588-1363
Practice Address - Street 1:2860 OCEAN AVE
Practice Address - Street 2:APT C1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3166
Practice Address - Country:US
Practice Address - Phone:718-407-9086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307199363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner