Dixon, Denise
Dixon, Denise is an sole proprietor health care provider with primary practice located at 646 Main St 2Nd Floor, Suite 203, Port Jefferson NY 11777-2235. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Dixon, Denise can be contacted via phone (631) 456-9426.Contact Information
Primary practice address
646 Main St 2Nd Floor, Suite 203
Port Jefferson NY 11777-2235
Phone: (631) 456-9426
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 015481 | New York |
Profile Details
| NPI number | 1457394983 |
|---|---|
| LBN Legal business name | Dixon, Denise |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 13th, 2006 |
| Last updated | Oct 27th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457394983 | NPPES |
| New York | Other | VN2811 | MEDICARE |
| New York | MEDICAID | 02794076 | MEDICARE |
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