Provider Demographics
NPI:1285830067
Name:GRAMEGNA-DIXON, DINA
Entity Type:Individual
Prefix:MRS
First Name:DINA
Middle Name:
Last Name:GRAMEGNA-DIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DINA
Other - Middle Name:
Other - Last Name:GRAMEGNA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:2171A BAY RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-5952
Mailing Address - Country:US
Mailing Address - Phone:718-234-9676
Mailing Address - Fax:718-234-9676
Practice Address - Street 1:2171A BAY RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5952
Practice Address - Country:US
Practice Address - Phone:718-234-9676
Practice Address - Fax:718-234-9676
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335255363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily