Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0201X | Pediatric Allergist | 150399 | NY |
N | 2080P0214X | Pediatric Pulmonologist | 150399 | NY |
NPI | 1962547612 |
---|---|
Provider Name | Dr. Mary Fac Dimaio |
First Address | New York, NY 10021 |
Second Address | New York, NY 10021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E62574 | (02) |