MEDICARE: DR. DIANE DIGIACOMO M.D.

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	2084P0804X	Child & Adolescent Psychiatry Physician	194248	NY

General Provider Information

NPI Number	:	1215146675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANE DIGIACOMO M.D.

Provider Business Mailing Address
First Line	:	111 BREWERY RD
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-6115
Country	:	US
Telephone Number	:	845-708-6025
Fax Number	:	845-708-6033

Provider Business Practice Location Address
First Line	:	111 BREWERY RD
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-6115
Country	:	US
Telephone Number	:	845-708-6025
Fax Number	:	845-708-6033

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

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	08/16/2025

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