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General NPI Number Information
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NPI Number | 1720422579
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Entity Type | Individual
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Provider Name | MATTHEW ADAM DELMAURO M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/23/2013
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 120 E 56TH ST STE 800
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City | NEW YORK
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State | NY
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Zip | 10022-3607
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Country | US
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Telephone | 734-707-7514
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Fax |
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Provider Business Mailing Address
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Address Line | 2052 31ST ST APT A1
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City | ASTORIA
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State | NY
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Zip | 11105-2549
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Country | US
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Telephone | 513-313-6010
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 278130
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License Number State | NY
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