Provider Demographics
NPI:1578600664
Name:DINOVIS, JAMES PAUL (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PAUL
Last Name:DINOVIS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 NEEL CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-1370
Mailing Address - Country:US
Mailing Address - Phone:631-563-2467
Mailing Address - Fax:631-563-3213
Practice Address - Street 1:1 NEEL CT
Practice Address - Street 2:SUITE A
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-1370
Practice Address - Country:US
Practice Address - Phone:631-563-2467
Practice Address - Fax:631-563-3213
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003232213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00723524Medicaid
NY5021250001Medicare NSC
NY00723524Medicaid