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General NPI Number Information
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NPI Number | 1326717778
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Entity Type | Organization
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Legal Business Name | DIANA HEALTH FLORIDA 1 LLC
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Dates
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Enumeration Date | 09/09/2021
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Last Update Date | 08/23/2023
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Provider Practice Location Address
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Address Line | 520 BROADWAY FL 4
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City | NEW YORK
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State | NY
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Zip | 10012-4436
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Country | US
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Telephone | 908-268-8750
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Fax |
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Provider Business Mailing Address
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Address Line | 520 BROADWAY FL 4
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City | NEW YORK
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State | NY
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Zip | 10012-4436
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Country | US
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Telephone | 908-268-8750
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KATE CONDLIFFE
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Credential |
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Telephone | 917-750-9533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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