Healthcare Provider Details

I. General information

NPI: 1619232741
Provider Name (Legal Business Name): BRITTNEY DIANE DI BELLA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTNEY DIANE BORY

II. Dates (important events)

Enumeration Date: 07/04/2012
Last Update Date: 02/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HEALTHY WAY
OCEANSIDE NY
11572-1551
US

IV. Provider business mailing address

350 MOTOR PKWY SUITE #309
HAUPPAUGE NY
11788-5101
US

V. Phone/Fax

Practice location:
  • Phone: 516-632-4751
  • Fax: 516-336-2941
Mailing address:
  • Phone: 631-514-7600
  • Fax: 631-813-1472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number383585-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: