Provider Demographics
NPI:1124208541
Name:DIMONTE, SILVIA ROBERTA
Entity Type:Individual
Prefix:MRS
First Name:SILVIA
Middle Name:ROBERTA
Last Name:DIMONTE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SILVIA
Other - Middle Name:ROBERTA
Other - Last Name:DELIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:244 BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-3002
Mailing Address - Country:US
Mailing Address - Phone:516-484-9275
Mailing Address - Fax:
Practice Address - Street 1:4320 BELL BLVD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2865
Practice Address - Country:US
Practice Address - Phone:718-631-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35763-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist