Individual provider Active NPI

Angeline Chiara Masulit Dizon, R.N.

  • Registered Nurse
  • Woodside, NY
National Provider Identifier
1043615685
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
7796938 Issued in NY
Practice address
3912 55TH St
Woodside, NY 11377-3344
Phone
(917) 288-6519
NPI assigned
Oct 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 7796938 NY Primary

Addresses

Primary practice location

3912 55TH St
Woodside, NY 11377-3344

Mailing address

3912 55TH St
Woodside, NY 11377-3344
Phone (917) 288-6519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
7796938NYMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1043615685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3912 55TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773344",
            "telephone_number": "917-288-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3912 55TH ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773344",
            "telephone_number": "917-288-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIZON",
        "first_name": "ANGELINE CHIARA",
        "middle_name": "MASULIT",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "7796938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.