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Individual

MR. MARK DIBUONO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
260 CHRISTOPHER LANE, STE 3F, STATEN ISLAND, NY 10314-1607
(718) 317-5522
(718) 494-5714
Mailing address
260 CHRISTOPHER LANE, STE 3F, STATEN ISLAND, NY 10314-1607
(718) 317-5522
(718) 494-5714

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
156059
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01392396
NY
Enumeration date
12/02/2005
Last updated
04/20/2026
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