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NPI Code Detail

MEDICARE: DR. DIANE MARIE DINGMAN OD

MEDICARE: DR. DIANE MARIE DINGMAN OD
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
1152W00000XOptometristVUT0067991NY

General Provider Information

NPI Number : 1922032887
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DIANE MARIE DINGMAN OD
Provider Business Mailing Address
First Line : 5792 WIDEWATERS PKWY
Second Line :
City : SYRACUSE
State : NY
Zip : 13214-1847
Country : US
Telephone Number : 315-422-4412
Fax Number :
Provider Business Practice Location Address
First Line : 5792 WIDEWATERS PKWY
Second Line :
City : SYRACUSE
State : NY
Zip : 13214-1847
Country : US
Telephone Number : 315-422-4412
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 04/27/2019

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