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General NPI Number Information
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NPI Number | 1740242551
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Entity Type | Individual
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Provider Name | DIANE ELIZABETH WALSH PT
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Gender | Female
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 07/01/2016
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Provider Practice Location Address
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Address Line | 2902 ROUTE 130 TENBY PLAZA
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City | DELRAN
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State | NJ
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Zip | 08075-2525
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Country | US
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Telephone | 856-461-8331
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Fax | 856-461-9099
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Provider Business Mailing Address
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Address Line | 833 CHESTNUT ST STE 1402
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4404
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Country | US
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Telephone | 800-321-9999
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Fax | 267-339-3761
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00089700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA00573900
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License Number State | NJ
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