Healthcare Provider Details

I. General information

NPI: 1932785375
Provider Name (Legal Business Name): DIANE NICOLE MOYA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WORLDS FAIR DR
SOMERSET NJ
08873-1369
US

IV. Provider business mailing address

2 WORLDS FAIR DR
SOMERSET NJ
08873-1369
US

V. Phone/Fax

Practice location:
  • Phone: 732-537-0909
  • Fax: 732-564-9032
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number25MB13288200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number34.017888
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number25MB13288200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: