Organization Active NPI

Dizon Wellness Center LLC

  • Chiropractor
  • Haskell, NJ
National Provider Identifier
1619082229
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00553400 Issued in NJ
Legal business name
DIZON WELLNESS CENTER LLC
Practice address
1069 Ringwood Ave
Suite 215
Haskell, NJ 07420-1408
Phone
(973) 835-3400
Fax
(973) 835-3411
NPI assigned
Aug 21, 2006
Last updated
Feb 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Authorized official

Name
Dr. Marcelino Anthony Dizon, D.C.NPI 1689782955
Title
Chiropractor
Phone
(973) 835-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 38MC00553400 NJ Primary

Addresses

Primary practice location

1069 Ringwood Ave
Suite 215
Haskell, NJ 07420-1408

Mailing address

1069 Ringwood Ave
Suite 215
Haskell, NJ 07420-1408
Phone (973) 835-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070322000481 NJ Part B Supplier - Clinic/Group Practice 5294837886 Receives reassigned benefits from 1 practitioner
Practice locations: Wayne, NJ

National Provider Directory

National Provider Directory

Locations

1069 Ringwood Ave
Ste 215
Haskell, NJ 07420
Phone (973) 728-8866

2282 Hamburg Tpke
Ste G
Wayne, NJ 07470
Phone (973) 706-7063

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297728000000",
    "number": "1619082229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1069 RINGWOOD AVE",
            "address_2": "SUITE 215",
            "city": "HASKELL",
            "state": "NJ",
            "postal_code": "074201408",
            "telephone_number": "973-835-3400",
            "fax_number": "973-835-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1069 RINGWOOD AVE",
            "address_2": "SUITE 215",
            "city": "HASKELL",
            "state": "NJ",
            "postal_code": "074201408",
            "telephone_number": "973-835-3400",
            "fax_number": "973-835-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIZON WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2011-02-15",
        "status": "A",
        "authorized_official_last_name": "DIZON",
        "authorized_official_first_name": "MARCELINO",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "973-835-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00553400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haskell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.