Provider Demographics
NPI:1073563367
Name:MORGENSTERN, DIANA M (MD)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:M
Last Name:MORGENSTERN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1601 CHERRY ST
Mailing Address - Street 2:SUITE 11511
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1321
Mailing Address - Country:US
Mailing Address - Phone:215-255-7822
Mailing Address - Fax:215-255-7825
Practice Address - Street 1:219 N BROAD ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19107-1519
Practice Address - Country:US
Practice Address - Phone:215-762-5181
Practice Address - Fax:215-762-5176
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD042650L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01243269Medicaid
PAE85184Medicare UPIN
PA671218Medicare PIN