National Provider Identifier
Edmond Spencer Dibble III
Edmond Spencer Dibble III is listed in the NPPES registry with a primary specialty of Peer Specialist in Farmington, NY and a listed phone number of (813) 892-9373.
Profile Overview
- NPI
- 1639837206
- Provider Type
- Individual
- Primary Specialty
- Peer Specialist
- Enumeration Date
- December 01, 2021
- Last Updated
- December 01, 2021
Practice Location
- 1533 Meadowbrook Lane
- Farmington, NY 14425
Phone: (813) 892-9373
Mailing Address
- 835 West Main Street
- Rochester, NY 14611
Specialties
- Peer Specialist (175T00000X)
Full Record
- NPI
- 1639837206
- Entity Type
- Individual
- Last Name
- Dibble
- First Name
- Edmond
- Middle Name
- Spencer
- Name Suffix
- III
- Mailing Street Address
- 835 West Main Street
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14611
- Mailing Country
- US
- Mailing Phone
- (585) 627-1777
- Practice Street Address
- 1533 Meadowbrook Lane
- Practice City
- Farmington
- Practice State
- NY
- Practice ZIP Code
- 14425
- Practice Country
- US
- Practice Phone
- (813) 892-9373
- Enumeration Date
- December 01, 2021
- Last Updated
- December 01, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- December 01, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Peer Specialist (175T00000X)