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Individual

CAROL DIMOND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2445 STATE ROUTE 30, SUNMOUNT DDSO, TUPPER LAKE, NY 12986-2502
(518) 359-7701
(518) 359-4133
Mailing address
2445 STATE ROUTE 30, SUNMOUNT DDSO, TUPPER LAKE, NY 12986-2502
(518) 359-7701
(518) 359-4133

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
155797
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01183251
NY
Enumeration date
02/03/2007
Last updated
07/20/2010
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