Provider Demographics
NPI:1740681873
Name:DIPRIMIO, ELIZABETH
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:DIPRIMIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SCHOOL LN
Mailing Address - Street 2:
Mailing Address - City:CARNEYS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08069-2520
Mailing Address - Country:US
Mailing Address - Phone:609-420-1403
Mailing Address - Fax:
Practice Address - Street 1:291 HARDING HWY
Practice Address - Street 2:
Practice Address - City:CARNEYS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08069-2344
Practice Address - Country:US
Practice Address - Phone:856-299-9229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00538800225X00000X
DEU1-0000265225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist