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Individual

MR. GERALD GENNARO DIMASO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
68 SEGUINE AVE, STATEN ISLAND, NY 10309-3723
(718) 356-6500
(718) 356-0348
Mailing address
39 DORA LN, HOLMDEL, NJ 07733-1672
(732) 888-1975

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
170623
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
170623
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01119180
NY
Enumeration date
02/09/2006
Last updated
01/18/2011
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