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General NPI Number Information
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NPI Number | 1295163046
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Entity Type | Individual
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Provider Name | DIANE CARBONE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/14/2013
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Last Update Date | 08/02/2018
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Provider Practice Location Address
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Address Line | 3429 SHORELINE DR
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City | ALLENWOOD
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State | NJ
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Zip | 08720
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Country | US
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Telephone | 732-233-5484
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Fax | 732-292-2814
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Provider Business Mailing Address
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Address Line | PO BOX 497 3429 SHORELINE DRIVE
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City | ALLENWOOD
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State | NJ
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Zip | 08720
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Country | US
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Telephone | 732-233-5484
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Fax | 732-292-2814
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | SI002965
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | SI002965
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License Number State | NJ
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