Provider Demographics
NPI:1174208755
Name:DIXON, PAIGE ELLEN (MD)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:ELLEN
Last Name:DIXON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W 26TH STREET
Mailing Address - Street 2:APT 21B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:929-400-5902
Mailing Address - Fax:
Practice Address - Street 1:281 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-420-3363
Practice Address - Fax:212-420-4615
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2024-02-02
Deactivation Date:2024-01-29
Deactivation Code:
Reactivation Date:2024-02-02
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program