Healthcare Provider Details

I. General information

NPI: 1992042238
Provider Name (Legal Business Name): DIANA NORMATOV SPECIAL EDUCATION
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2013
Last Update Date: 01/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 STRATFORD RD
PLAINVIEW NY
11803-2634
US

IV. Provider business mailing address

49 STRATFORD RD
PLAINVIEW NY
11803-2634
US

V. Phone/Fax

Practice location:
  • Phone: 917-291-1843
  • Fax:
Mailing address:
  • Phone: 917-291-1843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number854552
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier854552
Identifier TypeOTHER
Identifier StateNY
Identifier IssuerSPECIAL EDUCATOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: