Provider Demographics
NPI:1003206723
Name:CERINO, DIANA MARIE
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:MARIE
Last Name:CERINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:MARIE
Other - Last Name:PARESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2499
Mailing Address - Country:US
Mailing Address - Phone:347-614-6455
Mailing Address - Fax:
Practice Address - Street 1:90 HENRY ST
Practice Address - Street 2:
Practice Address - City:INWOOD
Practice Address - State:NY
Practice Address - Zip Code:11096-2335
Practice Address - Country:US
Practice Address - Phone:347-614-6455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator