| Luz Evangeline S Dizon Md Pc | |
|
235 N Pearl St Brockton MA 02301-1794 | |
| (508) 427-2525 | |
| Not Available |
| Full Name | Luz Evangeline S Dizon Md Pc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 235 N Pearl St, Brockton, Massachusetts |
| Authorized Official Name and Position | Luz E Dizon (OWNER) |
| Authorized Official Contact | 5088988650 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Luz Evangeline S Dizon Md Pc 235 N Pearl St Brockton MA 02301-1794 Ph: (508) 427-2424 | Luz Evangeline S Dizon Md Pc 235 N Pearl St Brockton MA 02301-1794 Ph: (508) 427-2525 |
| NPI Number | 1700935988 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 03/18/2020 |
| Certification Date | 03/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700935988 | NPI | - | NPPES |
| M19352 | Other | MA | BLUE SHIELD |
| 9774670 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 81052 (Massachusetts) | Primary |
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