Marissa Lynn Diemidio, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

330041 Issued in NY

Practice address

1574 Louis Kossuth Ave
Bohemia, NY 11716-1512

Phone

(631) 241-7594

NPI assigned

Oct 20, 2017

Sex

Female

Sole proprietor

Yes

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": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508457600000",
    "number": "1700397486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1574 LOUIS KOSSUTH AVE",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117161512",
            "telephone_number": "631-241-7594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1574 LOUIS KOSSUTH AVE",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117161512",
            "telephone_number": "631-241-7594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEMIDIO",
        "first_name": "MARISSA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-20",
        "last_updated": "2017-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "330041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Derosa
• Anthony J Detore, RN
• Christina Di Nardo
• Carla Diaz
• Diane Alana Dicarlo, LA.C, LMT
• Kathleen Mary Distefano, REGISTERED NURSE
• Matthew Dobkowski
• Christine F Doddy, LPN
• Seda Donmez, PHARM.D.
• Rebecca Dreyer, MPH, MSSA, LMSW

• Licensed Practical Nurse in Bohemia, NY
• Providers in Bohemia, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2017; 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.