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General NPI Number Information
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NPI Number | 1619270386
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Entity Type | Individual
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Provider Name | ANTHONY M. DINIZIO MD
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Gender | Male
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Dates
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Enumeration Date | 12/17/2010
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Last Update Date | 06/08/2016
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Provider Practice Location Address
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Address Line | 111 COLCHESTER AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-1473
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Country | US
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Telephone | 802-847-5057
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Fax | 802-847-4822
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Provider Business Mailing Address
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Address Line | 2 1/2 BEACON ST STE 199
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City | CONCORD
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State | NH
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Zip | 03301-4447
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Country | US
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Telephone | 603-228-1521
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Fax | 603-225-2510
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | LP02031
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 042.0013086
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License Number State | VT
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