Dizon Wellness Center LLC
Organization Active NPI Chiropractor · Haskell, NJ
NPI 1619082229 · NPPES record last updated Feb 15, 2011
Key facts
- NPI
- 1619082229
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 38MC00553400 (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
- Organization subpart
- No
Authorized official
- Name
- Dr. Marcelino Anthony Dizon, D.C.
- Title
- Chiropractor
- Phone
- (973) 835-3400
Practitioners 1
-
Marcelino Anthony Dizon, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070322000481 | NJ | Part B Supplier - Clinic/Group Practice | 5294837886 |
Receives reassigned benefits from 1 practitioner Practice locations: Wayne, NJ |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 38MC00553400 | NJ | Yes |
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
Other providers in Haskell, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.