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NPI Code Detail

MEDICARE: MS. DIANA STUBER

MEDICARE: MS. DIANA STUBER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian810822NY

General Provider Information

NPI Number : 1013001080
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANA STUBER
Provider Business Mailing Address
First Line : 750 E ADAMS ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13210-2306
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 725 E ADAMS ST FL 5
Second Line :
City : SYRACUSE
State : NY
Zip : 13210-2576
Country : US
Telephone Number : 315-464-5726
Fax Number : 315-464-2510
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 02/06/2024

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Directions to “ MS. DIANA STUBER ” Practice Location

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