Individual
DONALD A. DIRISI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
46 BARRA RD STE 101, BIDDEFORD, ME 04005-9461
(207) 282-5509
(207) 294-3543
Mailing address
46 BARRA RD STE 101, BIDDEFORD, ME 04005-9461
(207) 282-5509
(207) 294-3543
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA1662
ME
363AM0700X
Medical Physician Assistant
010518
NY
363AM0700X
Medical Physician Assistant
Primary
PA1662
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03417874
—
NY
Enumeration date
01/30/2007
Last updated
01/13/2025
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