MEDICARE: MS. DIANE DIASPARRA MS ED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency	835387	NY
2	103K00000X	Behavior Analyst	002157	NY

General Provider Information

NPI Number	:	1023464146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DIANE DIASPARRA MS ED

Provider Business Mailing Address
First Line	:	67 BIRCH DR
Second Line	:
City	:	PINE PLAINS
State	:	NY
Zip	:	12567-5516
Country	:	US
Telephone Number	:	631-335-3502
Fax Number	:

Provider Business Practice Location Address
First Line	:	67 BIRCH DRIVE
Second Line	:
City	:	PINE PLAINS
State	:	NY
Zip	:	12567-9998
Country	:	US
Telephone Number	:	631-335-3502
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2016
Last Update Date	:	10/16/2024

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