Provider Demographics
NPI:1558581165
Name:DIZOGLIO, BEATA ELZBIETA (MD)
Entity Type:Individual
Prefix:DR
First Name:BEATA
Middle Name:ELZBIETA
Last Name:DIZOGLIO
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:695 EDDY STREET
Mailing Address - Street 2:SUITE 21
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903
Mailing Address - Country:US
Mailing Address - Phone:401-272-1550
Mailing Address - Fax:
Practice Address - Street 1:695 EDDY ST
Practice Address - Street 2:SUITE 21
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4941
Practice Address - Country:US
Practice Address - Phone:401-272-1550
Practice Address - Fax:401-421-8792
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD12267207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology