Provider Demographics
NPI:1205352135
Name:DIXON, NOEL
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:
Last Name:DIXON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 STUYVESANT OVAL APT 2G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2140
Mailing Address - Country:US
Mailing Address - Phone:646-678-7417
Mailing Address - Fax:
Practice Address - Street 1:1 STUYVESANT OVAL APT 2G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-2140
Practice Address - Country:US
Practice Address - Phone:646-678-7417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide