MEDICARE: DR. DANIEL PATRICK DESIMONE 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	207X00000X	Orthopaedic Surgery Physician	181976	NY

General Provider Information

NPI Number	:	1932355757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL PATRICK DESIMONE M.D.

Provider Business Mailing Address
First Line	:	73 LOOKOUT RD
Second Line	:	TUXEDO PARK
City	:	TUXEDO PARK
State	:	NY
Zip	:	10987-4033
Country	:	US
Telephone Number	:	845-351-3362
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 W 69TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-4720
Country	:	US
Telephone Number	:	845-351-3362
Fax Number	:

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

Provider Enumeration Date	:	08/12/2008
Last Update Date	:	08/12/2008

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