# JOHN F. DIMITRI, DC, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336347442
- **Authorized official:** JOHN F DIMITRI D.C. (OWNER)
- **Authorized official phone:** (631) 224-7474

## Contact information

- **Practice address:** 11 CARLETON AVE, EAST ISLIP, NY 11730-2108
- **Practice address phone:** (631) 224-7474
- **Practice address fax:** (631) 224-8940
- **Mailing address:** 11 CARLETON AVE, EAST ISLIP, NY 11730-2108
- **Mailing address phone:** (631) 224-7474
- **Mailing address fax:** (631) 224-8940

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X009881 | NY | Yes |

## Other

- **Enumeration date:** 07/10/2007
- **Last updated:** 07/10/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | XBWLD1 | MEDICARE GROUP ID \# | NY |