MEDICARE: DR. DIANE AUSTIN D.A.,L.C.A.T.

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
1	221700000X	Art Therapist	000734	NY

General Provider Information

NPI Number	:	1083828503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANE AUSTIN D.A.,L.C.A.T.

Provider Business Mailing Address
First Line	:	5 W 86TH ST
Second Line	:	4D
City	:	NEW YORK
State	:	NY
Zip	:	10024-3603
Country	:	US
Telephone Number	:	212-787-0564
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 W 34TH ST
Second Line	:	1216
City	:	NEW YORK
State	:	NY
Zip	:	10001-3006
Country	:	US
Telephone Number	:	212-947-7111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/08/2007

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