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Mr. Damien Anthony Decollibus, PA
Surgical Physician Assistant in New York, New York
NPI 1114009115

Damien Anthony Decollibus is a Surgical Physician Assistant based in New York, NY and is specialized in Surgical. Damien Anthony Decollibus practices in New York, NY and has the professional credentials of PA. The NPI Number for Damien Anthony Decollibus is 1114009115 and holds a License No. 010067 (New York).

The current practice location address for Damien Anthony Decollibus is 100 E 77Th St, New York, NY and can be reached out via phone at 212-434-4264 and via fax at 212-434-4231. You can also correspond with Damien Anthony Decollibus through the mailing address at 100 E 77TH ST, NEW YORK, NY - 10075-1850 (mailing address contact number: 212-434-4264).

Location: 100 E 77Th St, New York, NY, 10075-1850
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Provider Profile Details
NPI Number
1114009115
Provider Name
Damien Anthony Decollibus
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
100 E 77Th St, New York, NY, 10075-1850
Phone Number
212-434-4264
Fax Number
212-434-4231
Provider Enumeration Date
10/19/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00246075 05 NY
institution
Provider Business Practice Location Address Details
Address
100 E 77Th St
City
State
Zip
10075-1850
Phone Number
212-434-4264
Fax Number
212-434-4231
person
Provider Business Mailing Address Details
Address
100 E 77Th St
City
State
Zip
10075-1850
Phone Number
212-434-4264
Fax Number
212-434-4231
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
010067 (New York)
Definition
Definition to come...
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