=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891981510
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DIANE TERESA OLDROYD APN,C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/17/2007
-----------------------------------------------------
Last Update Date | 09/17/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 411 NEW RD
-----------------------------------------------------
City | NORTHFIELD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08225-1648
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-383-6033
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2039 GARDEN RD
-----------------------------------------------------
City | MAYS LANDING
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08330-3926
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-625-1006
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ00141800
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------