Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 122359 | NY |
NPI | 1033186416 |
---|---|
Provider Name | Troy Everett Dixon |
First Address | Northport, NY 11768-2200 |
Second Address | Northport, NY 11768-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2006 |
Last Update Date | 10/04/2010 |