Provider Demographics
NPI:1013305655
Name:DI MONDA, ROBERT VINCENT (MS, ATC, EMT-B)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:VINCENT
Last Name:DI MONDA
Suffix:
Gender:M
Credentials:MS, ATC, EMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 DUNSTAN DR
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-1416
Mailing Address - Country:US
Mailing Address - Phone:516-282-6242
Mailing Address - Fax:516-463-6061
Practice Address - Street 1:230 HOFSTRA UNIVERSITY
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11549-2300
Practice Address - Country:US
Practice Address - Phone:516-463-6769
Practice Address - Fax:516-463-6061
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001528-12255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer