Provider Demographics
NPI:1215716881
Name:CAVIRIS, DIONYSIA ANTHI
Entity type:Individual
Prefix:
First Name:DIONYSIA
Middle Name:ANTHI
Last Name:CAVIRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 FARM HILL LN
Mailing Address - Street 2:
Mailing Address - City:EAST NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:11732-1004
Mailing Address - Country:US
Mailing Address - Phone:718-316-2405
Mailing Address - Fax:
Practice Address - Street 1:375 CAMINO DE LA REINA STE C
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3082
Practice Address - Country:US
Practice Address - Phone:718-316-2405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY352046363LF0000X
CANP95027404363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily