Provider Demographics
NPI:1750675294
Name:CHIOCE MEDICAL & DIAGNOSITC SERVICES PC
Entity Type:Organization
Organization Name:CHIOCE MEDICAL & DIAGNOSITC SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:F
Authorized Official - Last Name:DALTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-846-4390
Mailing Address - Street 1:854 BIRCHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763-1202
Mailing Address - Country:US
Mailing Address - Phone:631-846-4390
Mailing Address - Fax:
Practice Address - Street 1:854 BIRCHWOOD RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-1202
Practice Address - Country:US
Practice Address - Phone:631-846-4390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty