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NPI Code Detail

MEDICARE: ONE WORLD FAMILY MEDICINE PC

MEDICARE: ONE WORLD FAMILY MEDICINE PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician220557NY

General Provider Information

NPI Number : 1629061312
Entity Type Code : Organization
Provider Name (Legal Business Name) : ONE WORLD FAMILY MEDICINE PC
Provider Business Mailing Address
First Line : 6805 ROUTE 9
Second Line : SUITE 31
City : RHINEBECK
State : NY
Zip : 12572-1148
Country : US
Telephone Number : 845-876-3868
Fax Number : 845-876-3756
Provider Business Practice Location Address
First Line : 2565 ROUTE 212
Second Line :
City : WOODSTOCK
State : NY
Zip : 12498-2115
Country : US
Telephone Number : 845-679-6210
Fax Number : 845-679-6214
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. TRACIE L DIMARCO
Credential : M.D.
Telephone Number : 845-876-2174
Provider Enumeration Date : 08/26/2005
Last Update Date : 11/12/2009

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Directions to “ONE WORLD FAMILY MEDICINE PC ” Practice Location

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