Provider Demographics
NPI:1740264969
Name:DILIMETIN, GREGORY PHILIP (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:PHILIP
Last Name:DILIMETIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:250 PETTIT AVE
Mailing Address - Street 2:STE 4
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-3657
Mailing Address - Country:US
Mailing Address - Phone:516-409-0106
Mailing Address - Fax:516-409-0108
Practice Address - Street 1:250 PETTIT AVE
Practice Address - Street 2:STE 4
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-3657
Practice Address - Country:US
Practice Address - Phone:516-409-0106
Practice Address - Fax:516-409-0108
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY175749207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3300026OtherGHI
4265996OtherAETNA PPO POS
4C1078OtherHEALTH NET
000000053680OtherGHI HMO
390006749OtherRAILROAD MEDICARE
52067OtherVYTRA
NY01375539Medicaid
04798IOtherGHI MEDICARE
62K53OtherBLUE SHIELD
AE45764OtherMDNY HEALTHCARE
4211OtherMAGNACARE
00006810OtherINDEPENDENT HEALTH
175749OtherHIP
2228757OtherAETNA HMO
45042HOtherHEALTHCARE PARTNERS
AS912OtherOXFORD
4265996OtherAETNA PPO POS
4C1078OtherHEALTH NET