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General NPI Number Information
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NPI Number | 1790782993
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Entity Type | Individual
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Provider Name | CARRIE J. DIRAMIO MD
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Gender | Female
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 22481 ASPAN ST STE A
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City | LAKE FOREST
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State | CA
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Zip | 92630-1648
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Country | US
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Telephone | 949-240-2272
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Fax |
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Provider Business Mailing Address
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Address Line | 18 GRANITE ST
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City | WHITINSVILLE
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State | MA
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Zip | 01588-1908
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Country | US
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Telephone | 508-234-6311
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Fax | 508-234-4215
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 229410
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License Number State | MA
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