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1609541119 NPI number — ANTHONY JOSEPH DIMAURO PA-C, MSPAS

NPI Number: 1609541119
Health Care Provider/Practitioner: ANTHONY JOSEPH DIMAURO PA-C, MSPAS

Information about “1609541119” NPI (ANTHONY JOSEPH DIMAURO PA-C, MSPAS) exists in 1609541119 in HTML format HTML  |  1609541119 in plain Text format TXT  |  1609541119 in PDF (Portable Document Format) PDF  |  1609541119 in an XML format XML  formats.

NPI Number : 1609541119 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1609541119",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DIMAURO",
    "FirstName": "ANTHONY",
    "MiddleName": "JOSEPH",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "PA-C, MSPAS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 1119",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PROVIDENCE",
    "MailingAddressStateName": "RI",
    "MailingAddressPostalCode": "02901-1119",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1598 S COUNTY TRL",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EAST GREENWICH",
    "PracticeLocationAddressStateName": "RI",
    "PracticeLocationAddressPostalCode": "02818-1762",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "401-402-1040",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/16/2021",
    "LastUpdateDate": "03/24/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363AM0700X",
        "TaxonomyName": "Medical Physician Assistant",
        "LicenseNumber": "PA01363",
        "LicenseNumberStateCode": "RI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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