Healthcare Provider Details

I. General information

NPI: 1992912091
Provider Name (Legal Business Name): LIANY DIVEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 10/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 POND RD SUITE 401
ALLENTOWN PA
18104-2258
US

IV. Provider business mailing address

2100 MACK BLVD 2ND FLOOR
ALLENTOWN PA
18103-5622
US

V. Phone/Fax

Practice location:
  • Phone: 610-398-7700
  • Fax: 610-398-6917
Mailing address:
  • Phone: 484-884-0661
  • Fax: 484-884-0628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD439618
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301101882
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: