Individual
EVAN H DILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
92 FIESTA WAY, FORT LAUDERDALE, FL 33301-1415
(917) 968-9975
Mailing address
92 FIESTA WAY, FORT LAUDERDALE, FL 33301-1415
(917) 968-9975
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
166289
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01079065
—
NY
05
—
6363008
—
NJ
01
—
677U61
EMPIRE BCBS
NY
Enumeration date
10/24/2006
Last updated
01/06/2021
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