Individual
PAUL A DICONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 968-3222
Mailing address
26 ARROWOOD LN, MELVILLE, NY 11747-1545
(631) 470-4419
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
014222
NY
Other
Enumeration date
05/03/2011
Last updated
05/03/2011
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