Provider Demographics
NPI:1306389960
Name:GEONZON, DINAH KRISTINE CHEONG (RN WHNP- BC)
Entity Type:Individual
Prefix:MS
First Name:DINAH KRISTINE
Middle Name:CHEONG
Last Name:GEONZON
Suffix:
Gender:F
Credentials:RN WHNP- BC
Other - Prefix:MS
Other - First Name:DINAH KRISTINE
Other - Middle Name:
Other - Last Name:CHEONG-GEONZON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN WHNP BC
Mailing Address - Street 1:61 HARVARD DR
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-2006
Mailing Address - Country:US
Mailing Address - Phone:718-579-1737
Mailing Address - Fax:
Practice Address - Street 1:2130 FORD ST
Practice Address - Street 2:1ST FLR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5140
Practice Address - Country:US
Practice Address - Phone:718-676-1025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY421224363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health