Individual
DR. MICHAEL DISPENZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6906 MYRTLE AVE, GLENDALE, NY 11385-7264
(718) 628-8047
(718) 628-5419
Mailing address
6906 MYRTLE AVE, GLENDALE, NY 11385-7264
(718) 628-8047
(718) 628-5419
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
179288
NY
Other
Enumeration date
12/20/2006
Last updated
07/09/2007
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