MEDICARE: DALMACIO HONASAN FRANCISCO M.D.

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	207R00000X	Internal Medicine Physician	200393	NY

General Provider Information

NPI Number	:	1922084763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DALMACIO HONASAN FRANCISCO M.D.

Provider Business Mailing Address
First Line	:	8420 169TH ST
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11432-2034
Country	:	US
Telephone Number	:	718-206-3787
Fax Number	:	718-729-3780

Provider Business Practice Location Address
First Line	:	4528 21ST ST
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-5220
Country	:	US
Telephone Number	:	718-729-3760
Fax Number	:	718-729-3780

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

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	07/08/2007

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