Dizinno, Amanda
Dizinno, Amanda is an individual health care provider with primary practice located at 1509 Atkinson Rd Suite 1100, Lawrenceville GA 30043-7986. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Dizinno, Amanda can be contacted via phone (770) 995-2379.Contact Information
Primary practice address
1509 Atkinson Rd Suite 1100
Lawrenceville GA 30043-7986
Phone: (770) 995-2379
Fax: (770) 995-2385
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X |
Profile Details
| NPI number | 1851401731 |
|---|---|
| LBN Legal business name | Dizinno, Amanda |
| Credentials | LOTR |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Oct 27th, 2010 - about 15 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 | 1851401731 | NPPES |
| Other | 10077024 | AMERIGROUP | |
| Other | 371948 | AMERIGROUP | |
| Other | 375135543A | AMERIGROUP | |
| MEDICAID | 375135543A | AMERIGROUP |
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