Physician Compare National (NPI:1770674616)

HEALTHCARE PROVIDER: MARK ANTHONY DI MEDIO DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1770674616
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6103083860
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120208000039
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DIMEDIO
	Individual professional last name
Provider First Name	MARK
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	1983
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	500 SICKLERVILLE RD
	Group Practice or individual's line 1 address
City	WILLIAMSTOWN
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	080941215
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8566290645
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y