Individual
EDWARD A DIMITRY
Active
Individual
EDWARD A DIMITRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
25MA06224300
NJ
207RP1001X
Pulmonary Disease Physician
MD042441L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
222233003
HORIZON BC
NJ
01
—
222233003035
CIGNA
NJ
01
—
290008483
RAILROAD MEDICARE
NJ
01
—
5043040
AETNA
NJ
01
—
77U432
EMPIRE HEALTH
NJ
01
—
CHN
1216963
NJ
01
—
P400548
OXFORD
NJ
Enumeration date
08/10/2005
Last updated
02/03/2017
Update your record
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