Individual
DR. JOHN ROBERT DIMARTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
747 N BROADWAY, MASSAPEQUA, NY 11758-2395
(516) 795-5200
(516) 795-3865
Mailing address
747 N BROADWAY, SUITE 1, MASSAPEQUA, NY 11758-2395
(516) 795-5200
(516) 795-3865
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
157041
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0045289
GHI
—
01
—
CP486
OXFORD
—
Enumeration date
10/26/2006
Last updated
07/16/2015
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