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General NPI Number Information
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NPI Number | 1689874877
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Entity Type | Individual
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Provider Name | DIANE LI NATHAN MD
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Gender | Female
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 350 ENGLE STREET DEPT OF RADIOLOGY, ENGLEWOOD HOSPITAL AND MEDICAL CTR
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City | ENGLEWOOD
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State | NJ
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Zip | 07631
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Country | US
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Telephone | 201-894-3480
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 525
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City | MERCER ISLAND
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State | WA
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Zip | 98040-0525
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Country | US
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Telephone |
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD60319364
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME170676
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD442336
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MA12023800
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License Number State | NJ
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