Individual
LOUIS DIZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 E 17TH ST, NEW YORK, NY 10003-3804
(212) 598-6351
(212) 517-2137
Mailing address
301 E 17TH ST, NEW YORK, NY 10003-3804
(212) 598-6351
(212) 517-2137
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
284417
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023017332
—
VA
01
—
TN01KA
JOHN DEERE TENNCARE
TN
Enumeration date
07/19/2005
Last updated
11/02/2021
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