Healthcare Provider Details

I. General information

NPI: 1992435028
Provider Name (Legal Business Name): DIAMONTE A STINEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2022
Last Update Date: 06/13/2022
Certification Date: 06/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 EATON RD SE APT 2
WASHINGTON DC
20020-5938
US

IV. Provider business mailing address

1502 EATON RD SE APT 2
WASHINGTON DC
20020-5938
US

V. Phone/Fax

Practice location:
  • Phone: 202-360-2903
  • Fax:
Mailing address:
  • Phone: 202-360-2903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: