Individual ProviderMary DicarloInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4901 Lang Ave NE, Albuquerque, NM 87109-4495(505) 842-8171PECOS EnrollmentBased on the most recent information from CMS, provider Mary Dicarlo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1073778643Provider TypeIndividualFull NameDicarlo, MaryTitleDr.GenderFemaleSole ProprietorNoEnumeration Date7/23/2008Last Updated6/7/2013Contact InformationPractice LocationPractice Address4901 Lang Ave NE, Albuquerque, NM 87109-4495Phone(505) 842-8171Fax(505) 246-0687Mailing LocationMailing Address4901 Lang Ave NE, Albuquerque, NM 87109-4495Phone(505) 842-8171Fax(505) 246-0687Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense036121207Illinois