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General NPI Number Information
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NPI Number | 1215911987
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Entity Type | Individual
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Provider Name | DYANNE WESTERBERG DO
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Gender | Female
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 3156 RIVER RD
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City | CAMDEN
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State | NJ
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Zip | 08105-4242
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Country | US
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Telephone | 856-963-0126
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Fax | 856-365-0279
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Provider Business Mailing Address
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Address Line | 3 COOPER PLZ SUITE 502
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City | CAMDEN
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State | NJ
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Zip | 08103-1438
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Country | US
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Telephone | 856-342-2921
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Fax | 856-968-8499
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB08313300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS005360L
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License Number State | PA
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