Provider Demographics
NPI:1477530111
Name:DICPINIGAITIS, PAUL ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ANTHONY
Last Name:DICPINIGAITIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:651 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4938
Mailing Address - Country:US
Mailing Address - Phone:516-681-8822
Mailing Address - Fax:516-681-3322
Practice Address - Street 1:2800 MARCUS AVE STE 207
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1113
Practice Address - Country:US
Practice Address - Phone:516-622-2040
Practice Address - Fax:516-622-2977
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08399600207X00000X
NY204567207X00000X, 207XS0114X
FLME133003207X00000X
VA0101238417207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJA440ZOtherMEDICARE