Provider Demographics
NPI:1962547612
Name:DIMAIO, MARY FAC (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:FAC
Last Name:DIMAIO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:333 EAST 68TH STREET
Mailing Address - Street 2:APT 15A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-535-6402
Mailing Address - Fax:
Practice Address - Street 1:1440 YORK AVENUE
Practice Address - Street 2:SUITE P5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-988-5008
Practice Address - Fax:212-988-5017
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1503992080P0201X, 2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Not Answered2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E62574Medicare UPIN