Healthcare Provider Details

I. General information

NPI: 1578497525
Provider Name (Legal Business Name): ASHLEY DIMAGGIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2904 CONSTELLATION WAY
FINKSBURG MD
21048-2062
US

IV. Provider business mailing address

2904 CONSTELLATION WAY
FINKSBURG MD
21048-2062
US

V. Phone/Fax

Practice location:
  • Phone: 410-849-9017
  • Fax: 866-216-8668
Mailing address:
  • Phone: 410-849-9017
  • Fax: 866-216-8668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR199081
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: