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General NPI Number Information
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NPI Number | 1447390406
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Entity Type | Individual
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Provider Name | DENISE DIMARCO NP
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 233 E SHORE RD SUITE 101
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City | GREAT NECK
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State | NY
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Zip | 11023-2433
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Country | US
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Telephone | 516-487-2444
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Fax | 516-377-2446
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Provider Business Mailing Address
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Address Line | 189 GORDON PL
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City | FREEPORT
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State | NY
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Zip | 11520-5617
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Country | US
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Telephone | 516-377-3474
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F303948-1
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License Number State | NY
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