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NPI Code Detail

MEDICARE: DIANE GOLDBLUM-GRAFF MSN, APN, BC

MEDICARE: DIANE GOLDBLUM-GRAFF MSN, APN, BC
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
1364SP0809XAdult Psychiatric/Mental Health Clinical Nurse SpecialistNJ00113400NJ

General Provider Information

NPI Number : 1154449734
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE GOLDBLUM-GRAFF MSN, APN, BC
Provider Business Mailing Address
First Line : 222 NEW RD STE 405
Second Line :
City : LINWOOD
State : NJ
Zip : 08221-1283
Country : US
Telephone Number : 609-412-1717
Fax Number :
Provider Business Practice Location Address
First Line : 222 NEW RD STE 405
Second Line :
City : LINWOOD
State : NJ
Zip : 08221-1283
Country : US
Telephone Number : 609-412-1717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 02/26/2024

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