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Individual

DR. BEN R DIMICHINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
35 SHORE RD, EAST SETAUKET, NY 11733-3920
(631) 689-0202
(631) 689-2686
Mailing address
35 SHORE RD, EAST SETAUKET, NY 11733-3920
(631) 689-0202
(631) 689-2686

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004656
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01590385
NY
01
114212
VYTRA
01
1C1330
HEALTH NET
01
4450726
AETNA
01
792279
UNITED HEALTH CARE
01
AA47838
MDNY
01
P2545365
OXFORD
Enumeration date
08/31/2006
Last updated
04/02/2009
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