Healthcare Provider Details

I. General information

NPI: 1750893400
Provider Name (Legal Business Name): DIANA MARIE CIMINIERI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANA C FLORES CRNP

II. Dates (important events)

Enumeration Date: 11/02/2017
Last Update Date: 02/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 CHEW ST
ALLENTOWN PA
18102-3406
US

IV. Provider business mailing address

329 CATTAIL CT
PENNSBURG PA
18073-1569
US

V. Phone/Fax

Practice location:
  • Phone: 610-776-4500
  • Fax:
Mailing address:
  • Phone: 215-237-8232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN568561
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP018264
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: