Individual
GARY DICANIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
105 MEDFORD AVE, PATCHOGUE, NY 11772-1223
(631) 580-1000
(631) 580-0483
Mailing address
105 MEDFORD AVE, PATCHOGUE, NY 11772-1223
(631) 580-1000
(631) 580-0483
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
210161
NY
207V00000X
Obstetrics & Gynecology Physician
210161
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210161
LICENSE
NY
Enumeration date
10/19/2006
Last updated
11/03/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us