Provider Demographics
NPI:1376918524
Name:DIMURA, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:DIMURA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 SNYDERS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WYNANTSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12198-2733
Mailing Address - Country:US
Mailing Address - Phone:518-478-4496
Mailing Address - Fax:
Practice Address - Street 1:548 SNYDERS LAKE RD
Practice Address - Street 2:
Practice Address - City:WYNANTSKILL
Practice Address - State:NY
Practice Address - Zip Code:12198-2733
Practice Address - Country:US
Practice Address - Phone:518-478-4496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-13
Last Update Date:2015-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist