Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 180043 | NY |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 180043 | NY |
NPI | 1194833459 |
---|---|
Provider Name | Dr. Jose Maria Dizon |
First Address | New York, NY 10032-3725 |
Second Address | New York, NY 10032-3720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2006 |
Last Update Date | 15/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01550178 | (05) | NY |
B03695 | (02) | NY |