Provider Demographics
NPI:1124330105
Name:ZAMORA, DIONY P (PT)
Entity type:Individual
Prefix:
First Name:DIONY
Middle Name:P
Last Name:ZAMORA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E 54TH ST
Mailing Address - Street 2:APT. 26 C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4810
Mailing Address - Country:US
Mailing Address - Phone:917-847-4375
Mailing Address - Fax:
Practice Address - Street 1:250 E 54TH ST
Practice Address - Street 2:APT. 26 C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4810
Practice Address - Country:US
Practice Address - Phone:917-847-4375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013880171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor