Healthcare Provider Details

I. General information

NPI: 1306774096
Provider Name (Legal Business Name): ANNEMARIE LOUISE DIPAOLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 JOHNSON ST
STATEN ISLAND NY
10309-1148
US

IV. Provider business mailing address

161 FINLEY AVE
STATEN ISLAND NY
10306-5719
US

V. Phone/Fax

Practice location:
  • Phone: 718-979-5678
  • Fax:
Mailing address:
  • Phone: 347-869-0958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number031171
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: