1306389960 NPI number — MS. DINAH KRISTINE CHEONG GEONZON RN WHNP- BC

Table of content: MS. DINAH KRISTINE CHEONG GEONZON RN WHNP- BC (NPI 1306389960)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306389960 NPI number — MS. DINAH KRISTINE CHEONG GEONZON RN WHNP- BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEONZON
Provider First Name:
DINAH KRISTINE
Provider Middle Name:
CHEONG
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN WHNP- BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHEONG-GEONZON
Provider Other First Name:
DINAH KRISTINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN WHNP BC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1306389960
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
61 HARVARD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARTSDALE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10530-2006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-579-1737
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2130 FORD ST
Provider Second Line Business Practice Location Address:
1ST FLR
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11229-5140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-676-1025
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/29/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LW0102X , with the licence number:  421224 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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