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:
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Health care specialties

SpecialtyCodeLicense #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 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851401731 NPPES
Other 10077024 AMERIGROUP
Other 371948 AMERIGROUP
Other 375135543A AMERIGROUP
MEDICAID 375135543A AMERIGROUP

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