Provider Demographics
NPI:1831360692
Name:DIMARIA, ANTHONY S (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:S
Last Name:DIMARIA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:80 MARCUS DR
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4230
Mailing Address - Country:US
Mailing Address - Phone:631-391-7887
Mailing Address - Fax:631-454-4163
Practice Address - Street 1:9028 VAN WYCK EXPY
Practice Address - Street 2:JHMC-NURSING HOME COMPANY INC., TRUMP PAVILION NURSING
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11418-2898
Practice Address - Country:US
Practice Address - Phone:718-206-5234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY157217207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine