Healthcare Provider Details

I. General information

NPI: 1992629752
Provider Name (Legal Business Name): DIANA VANESSA LUNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 CHILDS ST
NEW BRITAIN CT
06051-1709
US

IV. Provider business mailing address

137 CHILDS ST
NEW BRITAIN CT
06051-1709
US

V. Phone/Fax

Practice location:
  • Phone: 646-966-2902
  • Fax:
Mailing address:
  • Phone: 646-966-2902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number83
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: