Individual provider · Type 1 NPI

Damien Anthony Decollibus, PA

Surgical Physician Assistant · New York, NY

NPI number 1114009115 Active

Practice location

100 E 77th St, Division Of Vascular Surgery
New York, NY 10075-1850

Fax (212) 434-4231

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X010067 (NY)

Surgical Physician Assistant: Definition to come...

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About NPI 1114009115

Damien Anthony Decollibus, PA's National Provider Identifier is 1114009115, issued on Oct 19, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in New York, NY. The record was last updated on Sep 10, 2008.