Individual
ANIS DIZDAREVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-9878
(212) 305-8980
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-9878
(212) 305-8980
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
230271
MA
207L00000X
Anesthesiology Physician
261268
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
261268
NY
Other
Enumeration date
09/22/2006
Last updated
06/09/2011
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