Active NPI
Marc Diberardino
- Veterinarian
- Orange, CT
National Provider Identifier
1902166135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Veterinarian
- License
- 003189
- Practice address
- 356 Boston Post Rd
Orange, CT 06477-3508 - Phone
- (203) 795-6091
- NPI assigned
- May 22, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 003189 | CT | Primary |
Addresses
Primary practice location
356 Boston Post Rd
Orange, CT 06477-3508
Mailing address
356 Boston Post Rd
Orange, CT 06477-3508
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 |
|---|---|---|---|
| 003189 | CT | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337644800000",
"number": "1902166135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "356 BOSTON POST RD",
"city": "ORANGE",
"state": "CT",
"postal_code": "064773508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "356 BOSTON POST RD",
"city": "ORANGE",
"state": "CT",
"postal_code": "064773508",
"telephone_number": "203-795-6091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIBERARDINO",
"first_name": "MARC",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-05-22",
"last_updated": "2012-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "174M00000X",
"taxonomy_group": "",
"desc": "Veterinarian",
"state": "CT",
"license": "003189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.