Individual
JASON DIBARTOLOMEIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6612 LINCOLN AVE, LOCKPORT, NY 14094-6109
(716) 243-6154
Mailing address
6612 LINCOLN AVE, LOCKPORT, NY 14094-6109
(716) 243-6154
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/06/2015
Last updated
07/06/2015
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