Provider Demographics
NPI:1306933122
Name:DIMAIO, PAULA ESTELLE (DC)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:ESTELLE
Last Name:DIMAIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 MACDADE BLVD # A
Mailing Address - Street 2:
Mailing Address - City:MILMONT PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19033-3624
Mailing Address - Country:US
Mailing Address - Phone:610-534-2273
Mailing Address - Fax:610-534-4629
Practice Address - Street 1:1004 MACDADE BLVD # A
Practice Address - Street 2:
Practice Address - City:MILMONT PARK
Practice Address - State:PA
Practice Address - Zip Code:19033-3624
Practice Address - Country:US
Practice Address - Phone:610-534-2273
Practice Address - Fax:610-534-4629
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAD.C. 004582 - L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1240487OtherDPW PA
232745490OtherTAX ID #
PADI 661829OtherBC/BS
PA1240487OtherDPW PA