Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 062061 | NY |
NPI | 1033776570 |
---|---|
Provider Name | Dr. Sundine Chizzonite |
First Address | Poughkeepsie, NY 12601-1173 |
Second Address | Poughkeepsie, NY 12601-1173 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2019 |
Last Update Date | 23/09/2021 |