Roberto C Dimambro, CASAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

12213 Issued in NY

Practice address

79 Glenridge Rd
Glenville, NY 12302-4523

Phone

(518) 952-8408

NPI assigned

May 8, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1457796146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 SULLIVAN LN",
            "city": "ARGYLE",
            "state": "NY",
            "postal_code": "128091102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 GLENRIDGE RD",
            "city": "GLENVILLE",
            "state": "NY",
            "postal_code": "123024523",
            "telephone_number": "518-952-8408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1724 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121803320",
            "country_code": "US",
            "telephone_number": "518-687-7739",
            "fax_number": "518-272-2149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIMAMBRO",
        "first_name": "ROBERTO",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "CASAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-08",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "12213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Deconno
• Janice Teresa Dempster, LSP
• Amy Marie Devito, OTR/L
• Timothy D Dickinson
• Ciara Diemer, LCSW
• Mark Dimartino, L.C.S.W.
• Timothy Donnelly
• Amy Donovan, D.C.
• Thomas C Dowling
• Dr Paul Baumgarten

• Addiction (Substance Use Disorder) Counselor in Glenville, NY
• Providers in Glenville, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.