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Individual
KRISTINA THERESA DIMEZZA
Active
Individual
KRISTINA THERESA DIMEZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
019235
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04354629
—
NY
Enumeration date
11/17/2015
Last updated
11/18/2021
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