Healthcare Provider Details

I. General information

NPI: 1487535951
Provider Name (Legal Business Name): ALTHEA M DINZEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 WATERS PL
BRONX NY
10461-2723
US

IV. Provider business mailing address

1500 WATERS PL
BRONX NY
10461-2723
US

V. Phone/Fax

Practice location:
  • Phone: 929-348-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number327638
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: