Healthcare Provider Details

I. General information

NPI: 1700117850
Provider Name (Legal Business Name): DIANE MARIE LAPIDUS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2010
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 MANSION ST
POUGHKEEPSIE NY
12601-2309
US

IV. Provider business mailing address

PO BOX 456
SPRING GLEN NY
12483-0456
US

V. Phone/Fax

Practice location:
  • Phone: 845-471-4243
  • Fax:
Mailing address:
  • Phone: 845-647-5113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number335398
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: