Dicanio, Gary

Dicanio, Gary is an individual health care provider with primary practice located at 2780 Middle Country Rd , Lake Grove NY 11755-2124. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Dicanio, Gary can be contacted via phone (631) 580-1000.

Contact Information

Primary practice address
2780 Middle Country Rd Lake Grove NY 11755-2124
Phone: (631) 580-1000
Fax: (631) 580-0483
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 210161 New York
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 210161 New York

Profile Details

NPI number 1770665721
LBN Legal business name Dicanio, Gary
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2006
Last updated Nov 27th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770665721 NPPES
New York Other 210161 LICENSE

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