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General NPI Number Information
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NPI Number | 1720622467
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Entity Type | Organization
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Legal Business Name | MATTHEW A. DELMAURO, M.D. PLLC
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Dates
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Enumeration Date | 11/06/2019
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 590 5TH AVE STE 1106
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City | NEW YORK
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State | NY
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Zip | 10036-4702
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Country | US
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Telephone | 212-466-6696
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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 | PHYSICIAN
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Name | DR. MATTHEW ADAM DELMAURO
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Credential | MD
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Telephone | 513-313-6010
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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 |
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License Number State |
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