Individual provider · Type 1 NPI

Tabor David Dizon, PA-C

Surgical Physician Assistant · Hartford, CT

NPI number 1154622553 Active

Practice location

80 Seymour Street, Hartford Hospital Critical Care Medicine
Hartford, CT 06102-5037

Call (860) 545-5200 Map

Mailing address

P.o. Box 415933, Hartford Hospital Professional Services
Boston, MA 02241-5933

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X002519 (CT)

Surgical Physician Assistant: Definition to come...

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About NPI 1154622553

Tabor David Dizon, PA-C's National Provider Identifier is 1154622553, issued on Nov 16, 2010. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Hartford, CT. The record was last updated on Feb 16, 2012.