Provider Demographics
NPI:1174825145
Name:MARY F. DIDIO, DC, PC
Entity Type:Organization
Organization Name:MARY F. DIDIO, DC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:F
Authorized Official - Last Name:DIDIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-673-1001
Mailing Address - Street 1:326 WALT WHITMAN RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTN STA
Mailing Address - State:NY
Mailing Address - Zip Code:11746-8703
Mailing Address - Country:US
Mailing Address - Phone:631-673-1001
Mailing Address - Fax:631-673-7055
Practice Address - Street 1:326 WALT WHITMAN RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTN STA
Practice Address - State:NY
Practice Address - Zip Code:11746-8703
Practice Address - Country:US
Practice Address - Phone:631-673-1001
Practice Address - Fax:631-673-7055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYXOO5481261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU64639Medicare UPIN