Provider Demographics
NPI:1043606957
Name:ROTH O'BRIEN, DIANA ALDONA (MD, MPH, BA)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:ALDONA
Last Name:ROTH O'BRIEN
Suffix:
Gender:F
Credentials:MD, MPH, BA
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:ALDONA ROTHENSTEIN
Other - Last Name:JULIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH, BA
Mailing Address - Street 1:111 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-4727
Mailing Address - Country:US
Mailing Address - Phone:917-846-1079
Mailing Address - Fax:
Practice Address - Street 1:225 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-1523
Practice Address - Country:US
Practice Address - Phone:201-775-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3045262085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology