Lisa C. Dimedio, D.O., P. C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MB06370800 Issued in NJ

Legal business name

LISA C. DIMEDIO, D.O., P. C.

Practice address

1652 Cooper St
Woodbury, NJ 08096-3768

Phone

(856) 227-8611

Fax

(856) 227-5716

NPI assigned

Dec 5, 2006

Last updated

Nov 30, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lisa Dimedio, D.O.

Title

President

Phone

(856) 227-8611

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1982762381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1652 COOPER ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080963768",
            "telephone_number": "856-227-8611",
            "fax_number": "856-227-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1652 COOPER ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080963768",
            "telephone_number": "856-227-8611",
            "fax_number": "856-227-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA C. DIMEDIO, D.O., P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "DIMEDIO",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-227-8611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB06370800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Woodbury, NJ
• Providers in Woodbury, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.