Provider Demographics
NPI:1669152708
Name:DIMARCO, GIONA (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:GIONA
Middle Name:
Last Name:DIMARCO
Suffix:
Gender:M
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 LAIRD AVE
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-1227
Mailing Address - Country:US
Mailing Address - Phone:724-550-0704
Mailing Address - Fax:
Practice Address - Street 1:435 N BROAD ST
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-1797
Practice Address - Country:US
Practice Address - Phone:724-458-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist