Provider Demographics
NPI:1144297045
Name:DIMARIA, FRANCINE PIERNA (DO)
Entity type:Individual
Prefix:
First Name:FRANCINE
Middle Name:PIERNA
Last Name:DIMARIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-2129
Mailing Address - Country:US
Mailing Address - Phone:631-667-9440
Mailing Address - Fax:631-667-3018
Practice Address - Street 1:2090 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-2129
Practice Address - Country:US
Practice Address - Phone:631-667-9440
Practice Address - Fax:631-667-3018
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212747207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH50603Medicare UPIN
NY5D7931Medicare ID - Type Unspecified