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Danielle Nicolette Dickson

Family Medicine in Bronx, NY. Individual provider (NPI-1).

NPI number1124580709
StatusActive
Last updated in NPPESDec 5, 2022

Details

NPI
1124580709
Entity type
Individual (NPI-1)
Name
Danielle Nicolette Dickson
Sex
Female
Sole proprietor
No
Enumeration date
Apr 3, 2019
Certification date
Dec 5, 2022
Last updated
Dec 5, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine318920NYYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

111 E 210th St
Bronx, NY 10467-2401

Phone 718-920-4678

Mailing address

111 E 210th St
Bronx, NY 10467-2401

Phone 718-920-4678

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