Provider Demographics
NPI:1811355191
Name:DIMAS, GIOVANNI
Entity type:Individual
Prefix:
First Name:GIOVANNI
Middle Name:
Last Name:DIMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3316 87TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON HTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-1677
Mailing Address - Country:US
Mailing Address - Phone:929-258-9315
Mailing Address - Fax:
Practice Address - Street 1:3316 87TH ST
Practice Address - Street 2:
Practice Address - City:JACKSON HTS
Practice Address - State:NY
Practice Address - Zip Code:11372-1677
Practice Address - Country:US
Practice Address - Phone:929-258-6315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst