Jeanette O Dixon | Brooklyn, NY • PECOS Search

Jeanette O Dixon

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

150 55th St, Emergency Department, Brooklyn, NY 11220-2508

(718) 630-8718 (347) 493-4920

PECOS Enrollment

Based on the most recent information from CMS, provider Jeanette O Dixon does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 9:43 AM.

Profile Details

Provider ID
1497026280
Provider Type
Individual
Full Name
Dixon, Jeanette O
Credential
PA-C

Gender
Female
Sole Proprietor
Yes
Enumeration Date
1/25/2012
Last Updated
1/25/2012

Contact Information

Practice Location

150 55th St, Emergency Department, Brooklyn, NY 11220-2508

Unlisted Fax

Mailing Location

55 E 190th St Apt 52, Bronx, NY 10468-4540

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 015318 New York