Provider Demographics
NPI:1295979144
Name:DIBLASIO, PATTY MORELL (MD)
Entity type:Individual
Prefix:
First Name:PATTY
Middle Name:MORELL
Last Name:DIBLASIO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:409 FULTON ST
Mailing Address - Street 2:FL 2
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5103
Mailing Address - Country:US
Mailing Address - Phone:718-260-1000
Mailing Address - Fax:718-260-0072
Practice Address - Street 1:409 FULTON ST
Practice Address - Street 2:FL 2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5103
Practice Address - Country:US
Practice Address - Phone:718-260-1000
Practice Address - Fax:718-260-0072
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-22
Last Update Date:2021-06-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA1239702083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine