Provider Demographics
NPI:1245990266
Name:DINZEY, ARCHIBALDO
Entity type:Individual
Prefix:
First Name:ARCHIBALDO
Middle Name:
Last Name:DINZEY
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 1:60 MORROW AVE APT 6DN
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-8156
Mailing Address - Country:US
Mailing Address - Phone:917-854-7047
Mailing Address - Fax:
Practice Address - Street 1:50 HAMILTON ST STE 4
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2863
Practice Address - Country:US
Practice Address - Phone:917-854-7047
Practice Address - Fax:917-854-7047
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1218982103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist