Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 261077-1 | NY |
NPI | 1477794584 |
---|---|
Provider Name | Dr. Jon-Paul Philip Dimauro |
First Address | New Hyde Park, NY 11040-0000 |
Second Address | New Hyde Park, NY 11040-0000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2009 |
Last Update Date | 08/03/2012 |