Individual
DR. DONNA JOSE-DIZON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
24519 JERICHO TPKE, BELLEROSE, NY 11426-1414
(718) 343-6300
(718) 343-6311
Mailing address
5 EDNA DR, SYOSSET, NY 11791-3717
(516) 802-0216
(516) 802-0216
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
028748
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028748
PT LICENSE #
NY
05
—
03131000
—
NY
01
—
1164851671
ORGANIZATION NPI
—
01
—
37085
PT LICENSE #
CA
01
—
40QA01330300
PT LICENSE #
NJ
01
—
6723976
REGISTRATION CERTIFICATE
NY
Enumeration date
07/10/2009
Last updated
08/11/2022
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