Provider Demographics
NPI:1124030184
Name:BARBARA, DIANE (NP)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:
Last Name:BARBARA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2901
Mailing Address - Country:US
Mailing Address - Phone:914-681-3146
Mailing Address - Fax:914-682-6403
Practice Address - Street 1:688 WHITE PLAINS ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5015
Practice Address - Country:US
Practice Address - Phone:914-722-6300
Practice Address - Fax:914-722-2133
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303903207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q24963Medicare UPIN
NY0681G1Medicare ID - Type Unspecified