Individual
DIMITRI BAZIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3418 BROADWAY OFC 2, NEW YORK, NY 10031-7408
(212) 283-2099
Mailing address
565 W 125TH ST, NEW YORK, NY 10027-3424
(212) 470-1000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
P04485
NY
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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