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General NPI Number Information
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NPI Number | 1467683532
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Entity Type | Individual
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Provider Name | DIANA L PUNALES MOREJON PHD
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Gender | Female
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 380 MOUNTAIN RD APT 912
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City | UNION CITY
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State | NJ
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Zip | 07087-7306
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Country | US
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Telephone | 201-725-3865
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Fax |
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Provider Business Mailing Address
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Address Line | 21 LEXINGTON AVE
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-5715
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Country | US
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Telephone | 201-255-7985
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Fax | 201-621-4467
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 017710
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License Number State | NY
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