Provider Demographics
NPI:1477087989
Name:DINOZZI, AMBER RENE
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:RENE
Last Name:DINOZZI
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 1:9 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-1703
Mailing Address - Country:US
Mailing Address - Phone:631-682-8079
Mailing Address - Fax:
Practice Address - Street 1:9 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-1703
Practice Address - Country:US
Practice Address - Phone:631-682-8079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist