MEDICARE: DIANE MARIE TRIMARCHI

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	174400000X	Specialist	1407324201	NY

General Provider Information

NPI Number	:	1750909842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE MARIE TRIMARCHI

Provider Business Mailing Address
First Line	:	139 CEDAR GROVE CT
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-5703
Country	:	US
Telephone Number	:	718-873-3994
Fax Number	:

Provider Business Practice Location Address
First Line	:	139 CEDAR GROVE CT
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-5703
Country	:	US
Telephone Number	:	718-873-3994
Fax Number	:

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

Provider Enumeration Date	:	07/06/2020
Last Update Date	:	07/06/2020

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Directions to “ DIANE MARIE TRIMARCHI ” Practice Location

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