MEDICARE: DR. DIANE GARFINKLE

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	103T00000X	Psychologist	011429-1	NY

General Provider Information

NPI Number	:	1497001705
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANE GARFINKLE

Provider Business Mailing Address
First Line	:	6636 YELLOWSTONE BLVD
Second Line	:	APARTMENT 20H
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2510
Country	:	US
Telephone Number	:	718-897-6249
Fax Number	:

Provider Business Practice Location Address
First Line	:	6636 YELLOWSTONE BLVD
Second Line	:	APARTMENT 20H
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2510
Country	:	US
Telephone Number	:	718-897-6249
Fax Number	:

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

Provider Enumeration Date	:	07/24/2012
Last Update Date	:	07/24/2012

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