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General NPI Number Information
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NPI Number | 1033638523
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Entity Type | Individual
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Provider Name | DINA DICENSO
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Gender | Female
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 09/15/2017
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Provider Practice Location Address
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Address Line | 210 MONTROSE AVE
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City | BROOKLYN
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State | NY
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Zip | 11206-2351
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Country | US
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Telephone | 718-417-1117
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Fax | 718-417-1119
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Provider Business Mailing Address
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Address Line | 540 47TH ST
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City | BROOKLYN
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State | NY
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Zip | 11220-1311
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Country | US
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Telephone | 917-679-9742
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 342265
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License Number State | NY
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