Provider Demographics
NPI:1265567515
Name:DIOSZEGHY, JENNIFER SUZANNE (MD)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:SUZANNE
Last Name:DIOSZEGHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:SUZANNE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:MILLER 2013
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-383-1067
Mailing Address - Fax:913-588-6280
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:MILLER 2013
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-6917
Practice Address - Fax:913-588-6280
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS94-06204208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics