Provider Demographics
NPI:1174837900
Name:JUDITH DIVEN MD PC
Entity Type:Organization
Organization Name:JUDITH DIVEN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DIVEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-563-5777
Mailing Address - Street 1:520 WASHINGTON RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MOUNT LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:15228-2819
Mailing Address - Country:US
Mailing Address - Phone:412-563-5777
Mailing Address - Fax:412-563-0122
Practice Address - Street 1:520 WASHINGTON RD
Practice Address - Street 2:SUITE 203
Practice Address - City:MOUNT LEBANON
Practice Address - State:PA
Practice Address - Zip Code:15228-2819
Practice Address - Country:US
Practice Address - Phone:412-563-5777
Practice Address - Fax:412-563-0122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty