NPI Code Detail JSON Logo

1508908005 NPI number — DIANE S CORREIA DO

NPI Number: 1508908005
Health Care Provider/Practitioner: DIANE S CORREIA DO

Information about “1508908005” NPI (DIANE S CORREIA DO) exists in 1508908005 in HTML format HTML  |  1508908005 in plain Text format TXT  |  1508908005 in PDF (Portable Document Format) PDF  |  1508908005 in an XML format XML  formats.

NPI Number : 1508908005 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508908005",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CORREIA",
    "FirstName": "DIANE",
    "MiddleName": "S",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DO",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "711 STEWART AVENUE",
    "SecondLineMailingAddress": "SUITE 114",
    "MailingAddressCityName": "GARDEN CITY",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11530",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "516-227-3254",
    "MailingAddressFaxNumber": "516-998-4078",
    "FirstLinePracticeLocationAddress": "711 STEWART AVENUE",
    "SecondLinePracticeLocationAddress": "SUITE 114",
    "PracticeLocationAddressCityName": "GARDEN CITY",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11530",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "516-227-3254",
    "PracticeLocationAddressFaxNumber": "516-998-4078",
    "EnumerationDate": "02/12/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207L00000X",
        "TaxonomyName": "Anesthesiology Physician",
        "LicenseNumber": "175615 1",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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