MEDICARE: JOSEPH DIMAURO PA

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
1	363A00000X	Physician Assistant	006930	NY

General Provider Information

NPI Number	:	1730330358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH DIMAURO PA

Provider Business Mailing Address
First Line	:	94 SCRANTON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-3212
Country	:	US
Telephone Number	:	718-227-1007
Fax Number	:

Provider Business Practice Location Address
First Line	:	94 SCRANTON AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-3212
Country	:	US
Telephone Number	:	718-227-1007
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2008
Last Update Date	:	10/01/2008

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Directions to “ JOSEPH DIMAURO PA” Practice Location

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