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NPI Code Detail

MEDICARE: DR MICHAEL SCOTTO DICLEMENTE

MEDICARE: DR MICHAEL SCOTTO DICLEMENTE
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
1213E00000XPodiatrist005032NY

General Provider Information

NPI Number : 1770978421
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR MICHAEL SCOTTO DICLEMENTE
Provider Business Mailing Address
First Line : 373 LAKEVIEW AVE
Second Line :
City : ROCKVILLE CENTRE
State : NY
Zip : 11570-3015
Country : US
Telephone Number : 718-768-2768
Fax Number : 718-621-0339
Provider Business Practice Location Address
First Line : 2281 82ND ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-2603
Country : US
Telephone Number : 718-768-2768
Fax Number : 718-621-0339
Authorized Official
Title or Position : PODIATRIST
Name : DR. MICHAEL JOSEPH SCOTTO DICLEMENTE
Credential : D.P.M
Telephone Number : 718-768-2768
Provider Enumeration Date : 03/31/2015
Last Update Date : 03/31/2015

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