Individual
MISS MADISON GRACE DIMATTEI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
303 MAIN ST APT 340, HEMPSTEAD, NY 11550-1448
(781) 439-8734
Mailing address
303 MAIN ST APT 340, HEMPSTEAD, NY 11550-1448
(781) 439-8734
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
026269
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/17/2019
Last updated
02/06/2022
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