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General NPI Number Information
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NPI Number | 1245450485
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Entity Type | Individual
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Provider Name | DIAN CARONNA PT
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Gender | Female
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Dates
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Enumeration Date | 04/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 120 MEADOWCREST STREET SUITE 110
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City | GRETNA
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State | LA
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Zip | 70056
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Country | US
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Telephone | 504-391-7663
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Fax | 504-391-7668
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Provider Business Mailing Address
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Address Line | 1111 MEDICAL CENTER BLVD SUITE N804
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City | MARRERO
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State | LA
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Zip | 70072
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Country | US
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Telephone | 504-349-6845
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Fax | 504-347-9610
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 01398
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License Number State | LA
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