Active NPI
Diane Marie Aly, PA-C
- Physician Assistant
- New York, NY
National Provider Identifier
1447685276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 016933
- Practice address
- 630 W 168TH St
New York, NY 10032-3725 - Phone
- (212) 305-2862
- NPI assigned
- Sep 11, 2013
- Last updated
- Nov 12, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 016933 | NY | Primary |
Addresses
Primary practice location
630 W 168TH St
New York, NY 10032-3725
Mailing address
485 Monroe Avenue
Washington TWP, NJ 07676
Phone (201) 388-7649
Other names 1
- Diane Marie Demartino
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 |
|---|---|---|---|
| 016933 | NY | MD | Physician Assistant |
Interoperability endpoints
- did7008@direct.nyp.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573516800000",
"number": "1447685276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "485 MONROE AVENUE",
"city": "WASHINGTON TWP",
"state": "NJ",
"postal_code": "07676",
"telephone_number": "201-388-7649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 W 168TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323725",
"telephone_number": "212-305-2862"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALY",
"first_name": "DIANE",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-11",
"last_updated": "2019-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "016933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DIANE",
"last_name": "DEMARTINO",
"middle_name": "MARIE",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.