Provider Demographics
NPI:1275588196
Name:DIORIO, DOMINIC A (MD)
Entity Type:Individual
Prefix:
First Name:DOMINIC
Middle Name:A
Last Name:DIORIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CRUMP LN
Mailing Address - Street 2:
Mailing Address - City:MERCHANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-2624
Mailing Address - Country:US
Mailing Address - Phone:609-364-6901
Mailing Address - Fax:856-488-0291
Practice Address - Street 1:6 CRUMP LN
Practice Address - Street 2:
Practice Address - City:MERCHANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08109-2624
Practice Address - Country:US
Practice Address - Phone:609-364-6901
Practice Address - Fax:856-488-0291
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA22911207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services