Provider Demographics
NPI:1275216921
Name:MERINO, DIANA TERESA (APN)
Entity Type:Individual
Prefix:MISS
First Name:DIANA
Middle Name:TERESA
Last Name:MERINO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350C LAFAYETTE RD APT 2B
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2922
Mailing Address - Country:US
Mailing Address - Phone:908-967-1593
Mailing Address - Fax:
Practice Address - Street 1:809 N WOOD AVE STE B
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4037
Practice Address - Country:US
Practice Address - Phone:908-486-7773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14879000363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology