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General NPI Number Information
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NPI Number | 1154671386
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Entity Type | Individual
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Provider Name | JILLIAN DINO M.ED., MPS, TVI
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Gender | Female
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Dates
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Enumeration Date | 09/14/2012
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Last Update Date | 09/14/2012
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Provider Practice Location Address
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Address Line | 292 MADISON AVE 2ND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10017-6307
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Country | US
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Telephone | 212-418-0320
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Fax |
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Provider Business Mailing Address
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Address Line | 320 W 38TH ST APT 1910
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City | NEW YORK
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State | NY
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Zip | 10018-5237
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Country | US
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Telephone | 914-906-8474
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NY
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