Provider Demographics
NPI:1306515952
Name:DZINO, DINO
Entity type:Individual
Prefix:
First Name:DINO
Middle Name:
Last Name:DZINO
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:DINO
Other - Middle Name:
Other - Last Name:DZINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:500 UNICORN PARK DR
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-3377
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 UNICORN PARK DR
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-3377
Practice Address - Country:US
Practice Address - Phone:781-123-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral