Active NPI
Jennifer Michelle Dimarco, SPED
- Health Educator
- Staten Island, NY
National Provider Identifier
1073875456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- License
- 856704
- Practice address
- 188 Sneden Ave
Staten Island, NY 10312 - Phone
- (917) 923-0419
- NPI assigned
- Jun 12, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | 856704 | NY | Primary |
Addresses
Primary practice location
188 Sneden Ave
Staten Island, NY 10312
Mailing address
188 Sneden Ave
Staten Island, NY 10312-3628
Phone (917) 923-0419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 856704 | NY | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339459200000",
"number": "1073875456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "188 SNEDEN AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103123628",
"telephone_number": "917-923-0419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "188 SNEDEN AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10312",
"telephone_number": "917-923-0419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIMARCO",
"first_name": "JENNIFER",
"middle_name": "MICHELLE",
"name_prefix": "Ms.",
"credential": "SPED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-12",
"last_updated": "2012-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "NY",
"license": "856704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.