Provider Demographics
NPI:1619403755
Name:DESIMONE, NEAL
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:
Last Name:DESIMONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BURKE DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07727-3846
Mailing Address - Country:US
Mailing Address - Phone:732-492-9012
Mailing Address - Fax:
Practice Address - Street 1:7 BURKE DR
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NJ
Practice Address - Zip Code:07727-3846
Practice Address - Country:US
Practice Address - Phone:732-492-9012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other