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Individual

DR. ALITA LOGRONO DIZON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
377 JERSEY AVE, SUITE 460, JERSEY CITY, NJ 07302-4325
(201) 332-4110
(201) 332-4122
Mailing address
377 JERSEY AVE, SUITE 460, JERSEY CITY, NJ 07302-4325
(201) 332-4110
(201) 332-4122

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
25MA06172900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1067339
HORIZON NJ HEALTH
NJ
01
21149154242
BEECH STREET
NJ
01
23165
UHP
NJ
01
2702975014
CIGNA
NJ
01
2702975016
CIGNA
NJ
01
41N14
EMPIRE BCBS
NY
01
5097587
AETNA
NJ
05
7437901
NJ
01
P2673595
OXFORD
NJ
Enumeration date
08/30/2006
Last updated
10/26/2010
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