Provider Demographics
NPI:1639144389
Name:DIROMA, AGOSTINO STEPHEN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:AGOSTINO
Middle Name:STEPHEN
Last Name:DIROMA
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1116 ALLISON DR
Mailing Address - Street 2:
Mailing Address - City:DERIDDER
Mailing Address - State:LA
Mailing Address - Zip Code:70634-2944
Mailing Address - Country:US
Mailing Address - Phone:337-463-5468
Mailing Address - Fax:337-463-5468
Practice Address - Street 1:1585 3RD ST
Practice Address - Street 2:MEDDAC-FP
Practice Address - City:FORT POLK
Practice Address - State:LA
Practice Address - Zip Code:71459-5102
Practice Address - Country:US
Practice Address - Phone:337-531-3494
Practice Address - Fax:337-531-3551
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant