| Doctor Name: | KIMBERLY DINUZZO |
| NPI Number: | 1669813028 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSED |
| License Number: | 726281131 |
| Business Practice Address: | 2500 Pond Vw Suite 102a Castleton, NY - 120339750 |
| Business Phone Number: | 5184776072 |
| Business Fax Number: | 5184776074 |
| Mailing Address: | 2500 Pond Vw, Suite 102a CASTLETON |
| State: | NY |
| Postal Code: | 120339750 |
| Phone Number: | 5184776072 |
| Fax Number: | 5184776074 |
| NPI Enumeration Date: | 07/15/2013 |
| NPI Last Update Date: | 07/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | 726281131 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |