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General NPI Number Information
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NPI Number | 1629589734
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Entity Type | Individual
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Provider Name | MARIA DEDIOS FNP
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Gender | Female
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Dates
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Enumeration Date | 10/16/2017
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Last Update Date | 10/16/2017
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Provider Practice Location Address
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Address Line | 130 EAST 77TH STREET 3 BLACK HALL
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City | NEW YORK
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State | NY
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Zip | 10075
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Country | US
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Telephone | 212-434-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 37 SUMMIT AVE APT 4D
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City | PORT CHESTER
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State | NY
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Zip | 10573-3858
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Country | US
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Telephone | 347-804-8927
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F341557-1
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License Number State | NY
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