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General NPI Number Information
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NPI Number | 1336347442
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Entity Type | Organization
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Legal Business Name | JOHN F. DIMITRI, DC, PLLC
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 11 CARLETON AVE
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City | EAST ISLIP
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State | NY
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Zip | 11730-2108
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Country | US
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Telephone | 631-224-7474
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Fax | 631-224-8940
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Provider Business Mailing Address
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Address Line | 11 CARLETON AVE
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City | EAST ISLIP
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State | NY
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Zip | 11730-2108
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Country | US
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Telephone | 631-224-7474
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Fax | 631-224-8940
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Authorized Official
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Title or Position | OWNER
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Name | JOHN F DIMITRI
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Credential | D.C.
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Telephone | 631-224-7474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X009881
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License Number State | NY
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